LIFE

FAQs

There are 24 Life Insurance companies registered with IRDAI.

There are two standard life products available in the market. 

They are (i) Saral Jeevan Bima – standard term life insurance product and (ii) Saral Pension – An immediate annuity plan

Please refer to the following  section of  Website of the Authority

irdai.gov.in>> Consumer Affairs>. List of Licensed Insurance entities>> List of Life Insurers>> 

Please refer to the following  section of  Website of the Authority

irdai.gov.in>> Consumer Affairs>. Products offered >> List of Life products>>

Please refer to the following  section of  Website of the Authority

irdai.gov.in>> Consumer Affairs>. Products offered >> List of Life products>>

Grace period is a period of 15 days for monthly modes and 30 days for yearly, half-yearly and quarterly modes available to the policyholder, from the date of the first unpaid premium, to pay the renewal premiums and keep the policy alive.   During the grace period, the insurance coverage will be available as per the terms and conditions of the policy. 

If the policy is discontinued by not paying the renewal premiums before the expiry of grace period, the policy is governed by the discontinued policy conditions, which will be mentioned in the terms and conditions of the policy. 

Yes, the policy benefits will remain in force during the grace period and the same will be mentioned in the applicable terms and conditions of the policy document.

As a policyholder, you can examine the insurance policy and opt out if you are not satisfied with any of the terms and conditions mentioned in the policy within 'free look' period of 15 days (30 days in case of electronic policies) from the date of receipt of policy document, by stating the reasons for your objection.

In case you opt out, the premium paid will be refunded after deductions for expenses like those for a medical examination, cost of proportionate risk cover, stamp duty, etc.

If it is a unit linked insurance policy (ULIP), in addition, the insurer can repurchase the units at the price on the cancellation date  

      Policyholders who have complaints are required to first approach the Grievance/Customer Complaints Cell of the concerned insurer. If you do not receive a response from insurer(s) within a reasonable period of time or dissatisfied with the response of the company, you may approach the Grievance Cell of the IRDAI or the Insurance Ombudsman. In case the claimant is not satisfied with the decision of Ombudsman, appeal can be filed at the appropriate judicial forum like civil courts.

If you have an Insurance Policy on personal lines, group insurance policies, policies issued to sole proprietorship and micro enterprises and have a grievance against an Insurance Company and their agents and intermediaries, then complaint can be filed by Policyholder or claimant/legal heirs, nominee or assignee.

One can approach Insurance Ombudsman with a written complaint only if the insurance company or insurance broker have rejected the complaint, not resolved it to the satisfaction of the complainant or not responded to it at all for a period of one month and where the value of the claim including expenses claimed is not above Rs 30 lakhs.

        (i) Buy insurance policy from a licensed insurance company.

       (ii) Buy insurance policy from only licensed agents/intermediaries/online

       (iii) Examine the benefits of different policies issued by the Insurers

       (iv) Understand the benefits and exclusions of the policy

       (v) Select the right policy

(vi) Provide complete material information in the proposal form like personal, family, health, contact details, etc.

(vii) Pay the premiums

(viii) After receiving the policy document, go through the same to understand its terms and conditions

(ix) Any discrepancies need to be brought to the notice of the Insurance Company immediately.

(x) During the policy term, pay your renewal premiums regularly and pdate your bank and personal details, if there is change, for hassle free claim settlements.

      Broadly the life insurance policies are categorized into two types – (i) Traditional plans and (ii) Unit Linked Insurance Plans (ULIPs).

 Traditional policies offer in-built guarantees and define maturity benefits through variety of products such as guaranteed maturity value. The investment risk in traditional life insurance policies is borne by life insurance companies. These policies are ideal for policy holders who are not market savvy and do not wish to take investment risks.

ULIPs, on the other hand provide a combination of risk cover and investment. In these policies, the investment risk is borne by the policyholder. More importantly they offer a flexibility to decide your risk taking profile.

The allocated (invested) portions of the premiums, after deducting all the charges and premium for risk cover under all policies in a particular fund as chosen by the policy holders, are pooled together to form a Unit fund.

The allocated (invested) portions of the premiums, after deducting all the charges and premium for risk cover under all policies in a particular fund as chosen by the policy holders, are pooled together to form a Unit fund.

Unit is a component of the Fund in a Unit Linked Policy

No.  IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving such phone calls are requested to lodge a police complaint

It is the policy document which provides full information, coverages, exclusions of the policy.

Report loss to the insurance company immediately and get a duplicate policy by complying with the formalities.  The duplicate policy confers the same rights as the original policy bond.

You can choose to have protection for a set period of time with Term Insurance. In the event of death or Total and Permanent Disability if the benefit is offered), your dependants will be paid a benefit. In Term Insurance, no benefit is normally payable if the life assured survives the term.

With whole life insurance, you are guaranteed lifelong protection. Whole life insurance pays out a death benefit so you can be assured that your family is protected against financial loss that can happen after your death. It is also an ideal way of creating an estate for your heirs as an inheritance.

An Endowment Policy is a savings linked insurance policy with a specific maturity date. Should an unfortunate event by way of death or disability occur to you during the period, the Sum Assured will be paid to your beneficiaries. On your surviving the term, the maturity proceeds on the policy become payable.

Under this plan, certain percent of the sum assured is returned to the insured person periodically as survival benefit. On the expiry of the term, the balance amount is paid as maturity value. The life risk may be covered for the full sum assured during the term of the policy irrespective of the survival benefits paid.

          These types of policies are taken on the life of the parent/children for the benefit of the child. By such policy the parent can plan to get funds when the child attains various stages in life. Some insurers offer waiver of premiums in case of unfortunate death of the parent/proposer during the term of the policy.

An annuity is an insurance product that pays out regular income. It is often used as part of a retirement portfolio.

Annuities can be broadly classified into two categories - immediate and deferred.

Immediate annuity:

In an immediate annuity, there is very little time difference between the accumulation phase and the disbursal phase. The period when the annuity policy holder makes his/ her premium payments is known as the accumulation phase. The disbursal phase is when the annuity payouts are being made to the policy holder. In case of immediate Annuity, the Annuity payment  from the Insurance Company starts immediately as per the terms and conditions of the policy. Purchase price (premium) for immediate Annuity is to be paid in Iumpsum in one instalment only.

Deferred annuity:

Deferred annuity is the exact opposite of an immediate annuity. In deferred annuity, there is a significantly long gap between the accumulation phase and the time the policy holder gets his/her payments annuitized. Due to a longer accumulation phase, payouts in a deferred annuity scheme start from a future date and not immediately.

It is a form to be filled in by the prospect in written or electronic or any other format as approved by IRDAI, where the prospect needs to provide all material information as required by the insurer in respect of a risk, in order to enable the insurer to take informed decision in the context of underwriting the risk, to determine the rates, advantages, terms and conditions of the cover to be granted.

"Material Information” means all important, essential and relevant information sought by the insurer in the Proposal Form and other connected documents to enable the Insurer to take informed decision in the context of underwriting the risk.  

The tax benefits are as per the Income Tax Act provisions/rules and are subject to change from time to time.  You may go through the Income Tax provisions for more information

The Authority has not barred Life insurance company (ies) from issuing multiple insurance policies to the same person or to a person who already holds life insurance policy (ies) from other life insurance company (ies). In case of unfortunate event of death, beneficiary can claim from all the life insurance policies taken by the insured. However, the person must disclose the complete details of previously brought policies to the insurance company and not doing so can result in misrepresentation which can be a ground for rejection of life insurance death claim.
Further, your attention is invited to section 45 of Insurance act, 1938 which contains provision on policy not to be called in question on grounds of misstatement after three years.”

The Authority has not barred any life insurance company from offering Term Insurance to individuals including those who are members of armed forces. However, the insurance companies offer insurance after assessing the mortality risk of the individual based on factors such as insurable interest, need for cover, income profile, life style habits, occupation, personal and family medical history etc. Further, it is the professional decision of the Insurance company whether to offer life Insurance or not based on their Board approved underwriting policy as Insurance is a long term contract between the Insurer and the Insured.”

Yes, the policy can be forfeited and the circumstances on which it can be forfeited will   be mentioned clearly in the Policy Document. 

It is informed that the term insurance plans offer high risk cover at relatively lower premiums and the Life Insurer carries big risk of paying the full sum assured in the event of claim even after payment of one instalment of premium. One of the elements of risk is called moral hazard where Insurer seeks to minimize it by underwriting the life proposed, as per their board approved underwriting rules, based on information submitted such as Age, Health, Financial status, Family.
By ascertaining the income earned by the life proposed through valid income proof, the Life Insurer assesses the commensurate need for Insurance, requirement of quantum of Insurance as well as premium paying capacity. This will ensure that people with no or little income do not obtain disproportionately high sum assured policies by concealing their real income/sources putting the Insurer on high risk. Life Insurers pay the claims out of premiums paid by all other policy holders which the Insurer holds in fiduciary capacity.
Further, Prevention of Money Laundering Act, 2002 also mandates that all financial institutions including Life Insurance Companies shall verify and document the legal sources of income before issuing financial products.”

 

“Saral Jeevan Bima” is a non-linked non-participating individual pure risk premium life insurance plan, which provides for payment of Sum Assured in lump sum to the nominee in case of the Life Assured’s unfortunate death during the policy term

The minimum age at entry is 18 years and the maximum is 65 years

The minimum term of insurance cover is for 5 years and the maximum is 40 years.

a) Minimum sum assured is Rs.500000/- (Five lakhs) and the Maximum sum assured is Rs. 25,00,000.

b) Insurers have the option of offering Sum Assured beyond Rs. 25,00,000.

a) Single premium,

b) Limited premium payment term of 5 and 10 years and

c) Regular premium payment term equal to the policy term.

a) Single premium in lump sum

b) Yearly

c) Half-yearly

d) Monthly (Only under ECS/NACH).

No. No maturity benefit is payable as this is a term insurance plan.

Only suicide clause (period of 12 months) is applicable as per the extant regulations.

Yes. A waiting period of 45 days is applicable from the date of commencement of risk. In case of revival of Policy, the waiting period shall not be applicable. During the waiting period, the claim amount on death of the life assured other than due to accident will be limited to an amount equal to 100% of all premiums received excluding taxes. 

One has to verify the approved sales literature for 

  1. features and benefits 
  2. limitations and exclusions 
  3. lapsation and its consequences 
  4. other disclosures. 

No surrender value is payable under the plan. However, policy cancellation value is payable for:

  • Single premium and
  • Payment of minimum 2 years premium under limited premium payment option.
  • No policy cancellation value is payable in respect of regular premium payment policies.

“Saral Pension” is a Single premium, Non-linked, Non-participating Immediate Annuity plan.

Minimum       :           40 years last birthday

Maximum      :           80 years last birthday

  1. Rs. 1000 per month
  2. Rs. 3000 per quarter
  3. Rs. 6000 per half year
  4. Rs. 12000 per annum

This is a Whole Life Product

Only Single premium (which is called purchase price)

Monthly, quarterly, half-yearly and yearly modes available and the annuity is payable as per the chosen mode by the annuitant.

Two options available in this product.

Option (i) - Life Annuity with Return of 100% Purchase Price

Option (ii) - Joint Life Survivor Annuity with Return of 100% of Purchase Price on death of last survivor.  (Joint Life – only spouse is covered)

Under Option (i) i.e. Life Annuity with Return of 100% of Purchase Price, 
Annuity is paid for the life of the annuitant.  

Under Option (ii) i.e. Joint Life Last Survivor Annuity with Return of 100% of Purchase Price, the annuity is first paid to the primary annuity for life.  After death of primary annuitant, if the spouse is surviving, the spouse continues to receive the same amount of annuity for life till his/her death.  

No maturity benefits available under the policy.

Under Option (i) i.e. Life Annuity with Return of 100% of Purchase Price, on the death of the annuitant, 100% of Purchase price (single premium excluding taxes) shall be returned to the nominee.

Under Option (ii) i.e. Joint Life Last Survivor Annuity with Return of 100% of Purchase Price, on the death of the last survivor, 100% of Purchase price (single premium excluding taxes) shall be returned to the nominee.

Yes, loan facility available in the product after six months from the date of commencement of the policy

Yes, the policy can be surrendered any time after six months from the date of commencement, if the annuitant or the spouse or any of the children of the annuitant is diagnosed as suffering from any of the critical illnesses specified in the Policy Document.   95% of the purchase price can be received as surrender value. 

The annuitant can seek refund of purchase price if he/she disagrees with the terms and conditions of the policy, within 15 days (30 days in case of electronic policies and policies obtained through distance mode) from the date of receipt of the policy document stating the reasons for objection.  The policyholder shall be entitled to a refund of the premium subject only to a deduction of stamp duty charges paid and annuity paid, if any. 

The Assignment of a policy of insurance is governed by the provisions of Section 38     of the  Insurance Act, 1938 and IRDAI (Fee for granting written acknowledgement of the receipt of Notice of Assignment or Transfer) Regulations, 2015.

As per Section 38 (1) of Insurance Act, 1938, an assignment of a policy of insurance,     wholly or in part, whether with or without consideration, is to be made only by an endorsement upon the policy itself or by a separate instrument, signed in either case by the transferor or by the assignor or his duly authorized agent and attested by at least one witness, specifically setting forth the fact of transfer or assignment and the reasons thereof, the antecedents of the assignee and the terms on which the assignment is made.

Yes, as per Section 38 (2) of Insurance Act, 1938, Insurer may decline to act upon any     endorsements where it has sufficient reason to believe that such transfer or assignment is not bona fide or is not in the interest of the policyholder or in public interest or is for the purpose of trading of insurance policy.

Yes, as per Section 38 (3) of Insurance Act, 1938. The insurer shall, before refusing to act upon the endorsement, record in writing the reasons for such refusal and communicate the same to the policyholder not later than thirty days from the date of the policyholder giving notice of such transfer or assignment.

The policyholder may prefer a claim to IRDAI within 30 days from the date of receipt of the communication from the insurer containing reasons for such refusal, as per Section 38 (4) of Insurance Act, 1938.  

No fee is required to be made for recording the assignments.  Bur for granting a written acknowledgment of the receipt of notice of assignment or transfer, Insurer can collect Rs. 50 (inclusive of all applicable taxes) in case of policies issued in     electronic form and Rs. 100 (inclusive of all applicable taxes) in case of policies issued other than electronic form. (as per Section 38 (7) of Insurance Act, 1938 and the Regulations issued by the Authority). 

The Nomination of a policy of life insurance is governed by the provisions of Section 39 of the Insurance Act, 1938 and IRDAI (Fee for Registering Cancellation or Change of Nomination) Regulations, 2015.

As per Section 39 (1) of Insurance Act, 1938, the holder of a policy of life insurance on his own life may, when effecting the policy or at any time before the policy matures for payment, nominate the person or persons to whom the money secured by the policy shall be paid in the event of his death.           

No fee is required to be made for registering a nomination at the time of effecting a policy of life insurance or any time thereafter.

Any nomination unless it is incorporated in the text of the policy itself, be made by an endorsement on the policy communicated to the insurer and registered by him in the records relating to the policy cannot be effectual, as per Section 39(2) provisions of Insurance Act, 1938.

Yes, nomination may at any time before the policy matures for payment be cancelled or changed by an endorsement or a further endorsement or a will, as the case may be, but unless notice in writing of any such cancellation or change has been delivered to the insurer, the insurer shall not be liable for any payment under the policy made. (Provisions of Section 39 (2) of Insurance Act, 1938).

Yes, for registering a cancellation or change of nomination by the holder of a policy of life insurance, Insurer may collect the fee of Rs. 50/- (inclusive of all applicable taxes) in respect of policies issued in electronic form and Rs.100/- (inclusive of all applicable taxes) in respect of policies issued in other than electronic form. (IRDAI Regulations).

A transfer or assignment of a policy made in accordance with section 38 shall automatically cancel a nomination, subject to the provisos of Section 39 of Insurance Act, 1938.

          As per Section 39 (5) of Insurance Act, 1938 provisions, in such case, the amount secured by the policy shall be payable to the policyholder or his heirs or legal representatives or the holder of a succession certificate, as the case may be.

          As per Section 39(11) of Insurance Act, 1938 provisions, where a policyholder dies after the maturity of the policy but the proceeds and benefit of his policy has not been made to him because of his death, in such a case,his nominee shall be entitled to the proceeds and benefit of his policy.

Yes, as per Regulation 3(2) it is mandatory for the Insurers maintain the electronic record of the policies and claims.

The records of policies and claims are maintained by the Insurers in electronic form shall be as per  policy framed by the Insurers and approved by their board and shall include the following.

i. Processing and electronic maintenance of records,

ii. Privacy and security of policyholder and claim data,

iii. Handling Virus, Vulnerability issues,

iv. Security of Hardware and Software,

v. Backups, Disaster Recovery and Business Continuity and

vi. Data Archival.

Yes, every policy of the Board is reviewed once in a year within 90 days from the expiry of the financial year.

The records including those held in electronic mode, pertaining to all the policies issued and all claims made in India shall be held in data centres located and maintained in India only.

Regulation 3(10) states that “Every insurer shall ensure that the records held are organized in such a manner as may be required for business use and easy retrieval so as to support policyholder service and compliance with the various laws, regulations, circulars, guidelines and such other regulatory framework as applicable from time to time.”

IRDA (Manner of Receipt of Premium) Regulations,2002  can be viewed at the following link.    

 https://www.irdai.gov.in/ADMINCMS/cms/frmGeneral_NoYearLayout.aspx?page=PageNo70&flag=1

The following are the manner in which the payment of premium can be made in the office/counter of the Insurer.

a)      Cash;

b)      Any recognized banking negotiable instrument such as cheques, including  demand drafts, pay orders, banker’s cheques drawn on any scheduled bank in India;

c)      Postal money orders;

d)      Credit or Debit Cards held in his name;

e)      Bank Guarantee or Cash Deposit;

f)        Internet;

g)      E-transfer;

h)      Direct credits via standing instructions of proposer or the policyholder or the life insured through bank transfers; and

i)        any other method of payment as may be approved by the Authority from time to time.

In all cases of risks covered by the policies issued by an insurer, the attachment of risk to an insurer will be in consonance with the terms of Section 64VB of the Act and except in the cases where the premium has been paid in cash, in all other cases the insurer shall be on risk only after the receipt of the premium by the insurer. The continuance of the risk or otherwise shall depend on the terms and conditions of the policy already entered into.

The IRDAI (Micro Insurance) Regulations, 2015 can be viewed at the following link.

https://www.irdai.gov.in/ADMINCMS/cms/frmGeneral_Layout.aspx?page=PageNo2480&flag=1

The list of various Micro Insurance policies of the Life Insurers can be viewed at the following link:

https://www.irdai.gov.in/ADMINCMS/cms/NormalData_Layout.aspx?page=PageNo271&mid=26.2

The Terms and Conditions of all Life Insurance products including Micro Insurance products can be viewed on the basis of the year of product issued by the Insurers at the following link:

www.irdai.gov.in  >> Products offered >> Life Insurers >> Terms and Conditions for FY

An insurer carrying on life insurance business may offer life micro insurance products as also general micro-insurance products, as provided herein:

Provided that where an insurer carrying on life insurance business offers any general micro-insurance product, he shall have a tie-up with an insurer carrying on general insurance business for this purpose, and subject to the provisions of Section 64VB of the Act, the premium attributable to the general micro insurance product may be collected from the prospect (proposer) by the insurer carrying on life insurance business, either directly or through any of the distributing entities of micro-insurance products as specified in Regulation (4) and made over to the insurer carrying on general insurance business:

 Provided further that in the event of any claim in regard to general micro insurance products, the insurer carrying on life insurance business or the distributing entities of micro-insurance products, as the case may be, as may be specified in the tie-up referred to in the first proviso, shall forward the claim to the insurer carrying on general insurance business and offer all assistance for the expeditious disposal of the claim.

“Micro-insurance agent” means the following entities or individuals who are appointed as Micro Insurance Agents in accordance to the IRDAI (Micro Insurance) Regulations, 2015.

(i) a Non-Government Organisation (NGO);

(ii) a Self-Help Group (SHG);

(iii) a Micro-Finance Institution (MFI)

A micro insurance agent may work with one Life Insurance Company and one General Insurance Company. In addition to this a Micro Insurance Agent may also work with Agriculture Insurance Company of India Ltd and with any one of the health insurance companies registered with the Authority.

In case of termination of a Micro Insurance Agent, the lapsed Micro Insurance policies of the terminated Micro Insurance agent may be allotted to another in force Micro Insurance Agent of the same insurer by obtaining the prior consent of such in-force micro insurance agent, by specifying that the objective of the allotment is to conserve and render policy service to the Micro Insurance policyholders. The Micro Insurance agent who is allotted such lapsed Micro Insurance Policies is entitled to remuneration / commission as per the File and Use of the respective micro insurance product. Remuneration / Commission shall be payable only on receipt of micro insurance premium.

In case of  complaint against micro insurance agent  the complaint/grievance can be registered with the Insurer. The insurer shall handle and dispose of complaints against a micro-insurance agent with speed and promptitude. The insurer shall send a quarterly report to the Authority regarding the handling of complaints/grievances, if any, against the micro-insurance agents.

The objective of IRDAI (Outsourcing of Activities by Indian Insurers) Regulations, 2017 is as follows.

(i) To ensure that insurers follow prudent practices on management of risks arising             out of outsourcing with a view to preventing negative systemic impact and to        protect the interests of the policyholders.

(ii) To ensure sound and responsive management practices for effective        oversight and adequate due diligence with regard to outsourcing of       activities by Insurers.

Outsourcing’ is defined as the use of third party services by the Insurer to perform activities that would normally be undertaken by the Insurer, either now or in future, but does not include services which are generally not expected to be carried out internally by the insurers such as             Legal services, Banking Services, Courier services, medical examination, forensic analysis.

The following are the outsourcing activities supporting policy services.

  1. Though the policy servicing remains an integral activity for the Insurer who is totally responsible for the services rendered, the activities that support Policyholder servicing are allowed to be outsourced.
  2. Where collection of premiums is outsourced by the Insurer, it shall put in place             procedures and ensure issuance of premium acknowledgements to the policyholders at the point of collection of premiums through such outsourced Service providers.

Provided, Insurers shall remain responsible for the acknowledgements issued and the date and time of such receipt shall be taken into account for considering the underlying benefits of an insurance contract

The Board of Directors approves and puts in place an Outsourcing Policy.

The Board of Directors of the Insurer,  constitute an Outsourcing Committee.

The Outsourcing Committee comprise of key management persons of the Insurer, and shall, at the minimum, include the Chief Risk Officer, Chief Financial Officer and Chief of             Operations.

No Insurer shall engage in India, an entity other than the following, as outsourcing service provider for the purpose of outsourcing where the activity outsourced is assessed as Material.

  1. Companies Registered under the relevant provisions of the Companies  Act,2013, or
  2. Limited Liability Partnerships registered under the relevant provisions of         the Limited Liability Partnership Act ,2008, or
  3. Registered Cooperative Societies registered under the cooperative Societies Act,1912    or
  4. Partnership firms registered under the Indian Partnership Act, 1932 or
  5. Entities formed under Public private partnership such as e-seva e-mitra, CSC.
  6. Any other entity as may be approved by the Authority to act as Outsourcing Service Provider.

Yes, the Insurers shall establish and maintain adequate contingency plans where the outsourced activity is material.

In respect of All outsourcing arrangements, Insurers shall ensure that adequate documentation is maintained to support the Insurer's satisfaction of the expectations in these Regulations.

  1. The documentation shall support the following aspects:
    1. Materiality assessments
    2. Adherence to the Insurer's outsourcing policy
    3. Cost benefit analysis
    4. Due diligence reviews
    5. Pricing assessments; and
    6. Risk evaluation
    7. The basis used to determine arm’s length distance while arriving at the pricing of activities that involve outsourcing with related party or group entity of the insurer or insurance intermediaries.  

        h)  Audit and Inspection reports as mentioned under Regulation (13).

  1. The documentation should be available for review by the Board and inspection by IRDAI as and when required.
  2. Such documentation shall be preserved for five years from the end of the outsourcing contract period by the Insurers. 

The opening of branches and operating units of Life Insurance companies are regulated as per IRDAI (Places of Business) Regulations,2015. It can be viewed at the following link.

https://www.irdai.gov.in/ADMINCMS/cms/frmGeneral_Layout.aspx?page=PageNo2594&flag=1

IRDAI is empowered to issue Regulations as per section 26 of the IRDA Act, 1999.

“Place of Business” means, a regional office, a zonal office, a divisional office, branch office or any subordinate office or any other office by whatever name called set up within India or a ‘representative or a liaison office of Indian Insurers’ or a  ‘Foreign Branch Office of Indian Insurer’ set up outside Indiaby the Insurers registered in India;

The Annual Business Plan, in addition to the business plans of the Insurer, shall contain the total number of new places of business proposed to be opened within India not only in the urban centers but also in semi-urban and rural centers. The Annual Business Plan shall specifically contain the names of places of business proposed to be opened within India, other than those places of business referred at Regulation 7 (ii), during the ensuing Financial Year for which an approval of the Authority is required in accordance with these Regulations.

The regulation can be viewed on page number 2 at the following link.

https://www.irdai.gov.in/ADMINCMS/cms/frmGeneral_Layout.aspx?page=PageNo2594&flag=1

New places of business proposed by the Insurer and approved by the Authority shall be opened within a period of one year from the date of approval of the Authority.

Yes, the closure of all places of business shall be reported to the Authority as a Return in Form – PB 4 of Schedule – 1 of these Regulations, within 15 days of the following month of such closure.

The Insurer  desiring to open a foreign branch office to carry on life insurance business shall make an application to the Authority in Form FPB – 2 of Scheduled – I along with the following information:

i) The regulatory architecture along-with the reporting, compliance and other requirements necessary for the establishment and conduct of insurance business of the jurisdiction where a foreign branch office is proposed to be set up.

ii) The expenses involved in establishing such a foreign branch office and the financial burden it will cast on the Insurer.

Provided the Insurer shall seek approval of the Authority to open a Foreign Branch Office outside India for which the Insurer has been granted the certificate of registration by the Authority.

“Rural  Sector”  means  the  places  or  areas  classified  as   “rural”   while

conducting the latest available decennial population census (Census of India);

 “Social Sector” includes unorganised sector, informal sector, economically

vulnerable  or  backward  classes  and other categories of persons, both in rural and

urban areas;

Unorganised Sector” includes self-employed workers such  as  agricultural

labourers, bidi workers, brick kiln workers, carpenters, cobblers, construction workers,

fishermen,  hamals,  handicraft  artisans,  handloom  and  khadi   workers,  lady tailors,

leather   and   tannery   workers,   papad   makers,  power   loom  workers,  physically

handicapped  self-employed  persons,  primary milk producers, rickshaw pullers, safai

karamcharis,salt growers, sericulture workers, sugarcane cutters, tendu leaf collectors

,toddy tappers, vegetable vendors, washerwomen, working women in hills, daily wagers , hired drivers and coolies or such other categories of persons;

“Informal Sector” includes small scale, self-employed workers typically at a

low   level  of   organisation   and  technology, with the primary objective of generating

employment  and  income,  with  heterogeneous  activities  like  retail  trade,  transport,

repair   and   maintenance,   construction,   personal   and   domestic   services   and

manufacturing,  with   the  work  mostly  labour  intensive, having often unwritten and

informal employer-employee relationship;

Every    insurer,   who   begins  to   carry   on  insurance business after the

commencement   of  the   Insurance Regulatory and Development Authority Act, 1999,

for the purposes of Sections 32B and 32C of the Insurance Act,1938 as amended from

time to time, shall ensure that it undertakes the following obligations, during the

 financial years indicated herein, pertaining to the persons in–

  1. Rural Sector

 (a)      In respect of a Life Insurer the following percentages of the total number of policies written in the respective years shown below.

Sr No

Financial year from inception

Percentage of number of policies

i

First year

  7%

ii

Second year

  9%

iii

Third year

12%

iv

Fourth year

14%

v

Fifth year

16%

vi

Sixth and seventh year

18%

vii

Eighth and ninth year

19%

viii

Tenth year and every year thereafter

20%

(b)         In respect of a General Insurer, the percentage of gross premium income written direct in the respective years shown below

Sr No

Financial year from inception

Percentage of gross premium written direct

i

First year

2%

ii

Second year

3%

iii

Third year to Seventh year

5%

iv

Eighth year

6%

v

Ninth year and every year thereafter

7%

                    (c)         In respect of Standalone Health Insurers

(i) 50% of the obligations prescribed for General Insurers

  1. Social Sector

In respect of all Insurers (Life, Non-Life, Standalone Health):

Age of the Insurer in years

“Percentage of Social Sector lives” computed  on the total business procured in the preceding financial year

1

0.5%

2

1%

3

1.5%

4

2%

5

2.5%

6

3%

7

3.5%

8

4%

9

4.5%

10 and above

5%

(Note: Total business for the purpose of these regulations is the total number of policies issued in case of individual insurance and number of lives covered in case of Group Insurance. In case of individual health insurance policies covering the lives of family members, the lives covered under such policy may be taken into account both in determination of target as well as actual performance)

Provided that in cases where an Insurer commences operations in the second half of the financial year and is in operations for less than six months as at 31st March of the relevant financial year, (i) no rural and social sector Obligations shall be applicable for the said period, and (ii) the annual obligations as indicated in the Regulations shall be reckoned from the next financial year which shall be considered as the first year of operations for the purpose of compliance to this regulations. However, in cases where an Insurer commences operations in the first half of the financial year, that financial year shall be treated as the first year of operations and the applicable obligations for the first year shall be 2500 lives for Social Sector. Similarly the obligations for Rural Sector shall be half of the percentage prescribed for the first year.

          It is an option to be exercised by the policyholder of a unit linked life insurance policy to receive the maturity proceeds in instalments.
 

No.  This option is available only to the policyholder on maturity of the policy

In case of ULIPs, the investment risk is borne by the policyholder. Normally, on maturity, the number of units available to the credit of the policy will be encashed at the Net Asset Value per unit as on date of maturity.  Thus, the maturity proceeds would depend on the Net Asset Value on a specific date, i.e., the date of maturity. Whereas, the settlement option provides an opportunity to the policyholder to encash the units at the Net Asset Value on the date of each instalment over a period not exceeding five years, instead of limiting to the value on one particular date.

No.  You can only take the maturity proceeds in instalments.

It depends on the periodicity made available by the Insurer– monthly, quarterly, half-yearly or yearly.

 

The period of settlement option can be for a maximum of 5 years from the date of maturity.

Yes.  Anytime during the 5 years you can opt for the complete withdrawal and the balance units as on the date of option will be encashed at the NAV rate prevailing on that date.

No.

No.  In case of the death of the policyholder during settlement option period, the nominee will be paid the remaining units at the NAV as on the date of intimation of death.

Switching of funds and partial withdrawals are not allowed during the settlement period.

Only Fund Management charges are allowed to be deducted during the settlement period.

The first instalment will be paid on the date of maturity.

         Except pension and variable insurance products, settlement option is available for all the other linked products.  The availability and details of the settlement option will be mentioned clearly in the terms and conditions of the policy.

        The policyholder continues to bear the risk during the settlement period as the balance will continue to stay invested in the segregated fund and its value is subject to market risks. It may go up or down basis the market performance of your fund portfolio.

       The funds will remain invested in the same segregated fund which was opted by the policyholder at the time of taking the policy or the segregated fund as on the date of maturity in case of fund switches exercised during the policy term.

The available number of units under the Policy shall be divided by the residual number of instalments to arrive at a number of units for each instalment which will then be multiplied by the net asset value on the date of payment.
For example, if the policyholder opts for settlement in five (5) annual instalments, the first instalment will be one-fifth (i.e., 1/5) of the number of units available to the credit of the policy on the date of maturity, multiplied by the NAV as on that date.The second instalment will be one-fourth (1/4) of balance number of units multiplied by the NAV as on that date and so on.
 

In such situation,the death benefit proceeds as per the terms and conditions of the policy shall become payable and settlement option will not be applicable.

No. Once the payment starts, the mode of payment of instalments cannot be changed except that you may withdraw the whole amount of fund value at any given point of time within the period.

Yes. The nomination remains valid till the last instalment is paid.

The information is not available as Individual policy related documents are not maintained by the Authority.

The information is not available as Individual policy related data is not maintained by the Authority.

The List of Life Insurance companies along with the address of the headquarters can be viewed at the following link

Click Here

The information is not available as the HR matters of the Insurance companies are not regulated by the Authority.

IRDAI is a Statutory Regulatory body. The liabilities of the regulated entities are not discharged by the Authority. However, it is also informed that in case of any grievance as a policyholder of any Life Insurance Company, the following Grievance Redressal Mechanism is put in place may be used for resolution of the same.

In the event of any complaint/grievance against insurer/s the applicant is required to first approach the Grievance/Customer complaints Cell of the concerned Insurer. In case of non-receipt of a response from insurer(s) with a reasonable period of time or are dissatisfied with the response of the company, approach the Grievance Cell of the IRDA at the following address:

Complaints against Life Insurance Companies:
General Manager,
Consumer Affairs Department,
Insurance Regulatory and Development Authority,
Survey No. 115/1, Financial District, Nanakramguda,
Gachibowli, Hyderabad – 500032
Email-id: complaints@irda.gov.in
Call Toll Free Number 155255.

If not satisfied with the Insurance Company’s response the applicant can also file a complaint with the Insurance Ombudsman of the State. The Authority directed all Insurers to mention in the policy documents information relating to the ombudsman. The Insurance Ombudsman is an independent office to provide speedy and cost effective resolution of grievances to the customers with regard to any grievances connected with claim settlement up to a limit of Rs. 30 Lakhs per case.

The Authority/IRDAI draws powers from IRDA Act 1999 and certain provisions of Insurance Act,1938.Section 14 of IRDA Act 1999 specifies duties, powers and functions of IRDAI.


“Section 14. DUTIES, POWERS AND FUNCTIONS OF AUTHORITY. --
(1)Subject to the provisions of this Act and any other law for the time being in force, the Authority shall have the duty to regulate, promote and ensure orderly growth of the insurance business and re-insurance business.
(2) Without prejudice to the generality of the provisions contained in sub-section (1), the powers and functions of the Authority shall include, -
(a) issue to the applicant a certificate of registration, renew, modify, withdraw, suspend or cancel such registration;
(b) protection of the interests of the policy holders in matters concerning assigning of policy, nomination by policy holders, insurable interest, settlement of insurance claim, surrender value of policy and other terms and conditions of contracts of insurance;
(c)specifying requisite qualifications, code of conduct and practical training for intermediary or insurance intermediaries and agents;
(d) specifying the code of conduct for surveyors and loss assessors;
(e) promoting efficiency in the conduct of insurance business;
(f) promoting and regulating professional organisations connected with the insurance and re-insurance business;
(g) levying fees and other charges for carrying out the purposes of this Act;
(h) calling for information from, undertaking inspection of, conducting enquiries and investigations including audit of the insurers, intermediaries, insurance intermediaries and other organisations connected with the insurance business;
(i) control and regulation of the rates, advantages, terms and conditions that may be offered by insurers in respect of general insurance business not so controlled and regulated by the Tariff Advisory Committee under section 64U of the Insurance Act, 1938 (4 of 1938);
(j) specifying the form and manner in which books of account shall be maintained and statement of accounts shall be rendered by insurers and other insurance intermediaries;
(k) regulating investment of funds by insurance companies;
(l) regulating maintenance of margin of solvency;
(m) adjudication of disputes between insurers and intermediaries or insurance intermediaries;
(n) supervising the functioning of the Tariff Advisory Committee;
(o) specifying the percentage of premium income of the insurer to finance schemes for promoting and regulating professional organisations referred to in clause (f);
(p) specifying the percentage of life insurance business and general insurance business to be undertaken by the insurer in the rural or social sector; and
(q) exercising such other powers as may be prescribed.”

Life Insurance Corporation of India is the only public sector Life Insurance company in India.

There are 23 private sector Life Insurance companies in India. They are:

S.NO

Insurance company

1

AEGON  Life Insurance Co. Ltd. 

2

Aviva Life Insurance Company India Limited

3

Bajaj Allianz Life Insurance Co. Ltd.

4

Bharti AXA Life Insurance Co. Ltd.

5

Birla Sun Life Insurance Co. Ltd 

6

Canara HSBC Oriental Bank of Commerce Life Insurance Co. Ltd.

7

DHFL Pramerica Life Insurance Co. Ltd.

8

Edelweiss Tokio Life Insurance Co. Ltd.

9

Exide Life Insurance Co. Ltd.

10

Future Generali India Life Insurance Co. Ltd.

11

HDFC Standard Life Insurance Co. Ltd 

12

ICICI Prudential Life Insurance Co. Ltd 

13

IDBI Federal Life Insurance Co. Ltd.

14

India First Life Insurance Co. Ltd.

15

Kotak Mahindra Old Mutual Life Insurance Co. Ltd 

16

Max Life Insurance Co. Ltd 

17

PNB MetLife India Insurance Co. Ltd.

18

Reliance Nippon Life Insurance Co. Ltd.

19

Sahara India Life Insurance Co. Ltd.

20

SBI Life Insurance Co. Ltd 

21

Shriram Life Insurance Co. Ltd.

22

Star Union Dai-ichi Life Insurance Co. Ltd.

23

Tata AIA Life Insurance Co. Ltd. 

 

The year wise policies sold by Life insurance companies and the total premium obtained by the Life insurers can be viewed in the Authority’s yearly Hand books which can be viewed on the website www.irdai.gov.in >Reports>Handbook on Indian insurance

The year wise total premium obtained by the Life insurers can be viewed in the Authority’s yearly Hand books which can be viewed on the website www.irdai.gov.in >Reports>Handbook on Indian insurance

Information sought is not available.as product wise new business data of Life insurance companies is not maintained by the Authority.

As per section 10(1) of IRDAI (Protection of Policyholders Interests) Regulations,2017 the policyholder has a free look period of 15 days (30 days in case of electronic policies and policies obtained through distance mode) from the date of receipt of the policy document, to review the terms and conditions of the policy and where the policyholder disagrees to any of those terms or conditions, he has the option to return the policy to the insurer for cancellation.

The year wise death claims settled and death claim amount paid  by Life insurance companies can be viewed in the Authority’s Annual reports which can viewed on the website www.irdai.gov.in >Reports>Annual reports of the Authority.

The information is not available as the details of claim settlement of individual policies of the insurers is not maintained by the Authority

The information is not available as the product type wise, product wise details of settlement of claims is not maintained by the Authority

The year wise death claims repudiated/rejected  by Life insurance companies can be viewed in the Authority’s Annual reports which can viewed on the website www.irdai.gov.in >Reports>Annual reports of the Authority.

Regulation 14 of IRDAI (Protection of Policyholders’ Interests) Regulations,2017 prescribes the Claims procedure in respect of a Life Insurance policy. The Regulations can be viewed at the following link

Click here

As per regulation 14(2)(i) of IRDAI (Protection of Policyholders’ Interests) Regulations,2017, a death claim under a life insurance policy shall be paid or be rejected or repudiated giving all the relevant reasons, within 30 days from the date of receipt of all relevant papers and required clarifications. However, where the circumstances of a claim warrant an investigation in the opinion of the insurer, it shall initiate the same at the earliest and complete such investigation expeditiously, in any case not later than 90 days from the date of receipt of claim intimation and the claim shall be settled within 30 days thereafter.

Also as per regulation 14(2)(iv) of IRDAI (Protection of Policyholders’ Interests) Regulations,2017, in respect of Maturity, Survival Benefit claims and Annuities, the Life Insurer shall initiate the claim process by sending intimation sufficiently in advance or send post-dated cheque or give direct credit to the bank account of claimant through any electronic mode approved by RBI, so as to pay the claim on or before the due date.

As per regulation 14(2)(ii) of IRDAI (Protection of Policyholders’ Interests) Regulations,2017. In respect of death claim if there is delay on the part of Insurer beyond the timelines mentioned in sub regulation 14(2)(i), the insurer shall pay interest at a rate, which is 2% above bank rate from the date of receipt of last necessary document

As per regulation 14(2)(iv) of IRDAI (Protection of Policyholders’ Interests) Regulations, 2017.In respect of Maturity, Survival Benefit claims and Annuities, in case of any delay on the part of the Insurer in settling the claim on due date, the life insurer shall pay interest at a rate, which is 2% above bank rate from the due date of payment or date of receipt of last necessary document from the insured/claimant, whichever is later.

According to Schedule III of IRDAI (Assets, Liabilities, and Solvency Margin of Life Insurance Business) Regulations, 2016 every insurer at all times shall maintain a control level of solvency i.e. solvency ratio of 150 percent. The Authority reviews solvency ratio among insurance companies on quarterly basis. The regulations can be viewed at IRDAI  Website under  CONSOLIDATED and GAZETTE NOTIFIED REGULATIONS. 

Also section 56 (1) of Insurance Act 1938 states that in the winding up of an insurance company and in the insolvency of any other insurer the value of the assets and the liabilities of the insurer in respect of life insurance business shall be ascertained separately from the value of any other assets or any other liabilities of the insurer and no such assets shall be applied to the discharge of any liabilities other than those in respect of life insurance business.

The information is not available as the details of the individual policies are not maintained by the Authority. However, the benefits and payments under the policy are based on the terms and conditions of the policy.

No

No. However, Securing the loans, either by way of insurance or other modes, is the prerogative of the lending institutions concerned which may be as per terms and conditions of the loan or may be as per the directives if any, prescribed by the regulator governing the lending institution.

The opening of branches and operating units of Life Insurance companies are regulated as per IRDAI (Places of Business) Regulations,2015. The same can be viewed at the following link.

Click here

IRDAI has not imposed any limits on cash payment. However as per Master circular on AML/CFT guidelines for Life Insurers dated 28/09/2015 cash payments beyond Rs.50000 should always be accompanied by PAN.

The Master circular can be viewed at the following link

Click here

According to section 6 of Insurance Act 1938, no insurer carrying on the business of life insurance in India or after the commencement of the Insurance Regulatory and Development Authority Act, 1999, shall be registered unless he has a paid-up equity capital of rupees one hundred crores.

9 Life Insurers are providing PMJJBY

  1. Tata AIA Life Insurance Co. Ltd.
  2. ICICI Prudential Life Insurance Co. Ltd
  3. HDFC Standard Life Insurance Co. Ltd
  4. SBI Life Insurance Co. Ltd
  5. Max Life Insurance Co. Ltd
  6. India First Life Insurance Co. Ltd
  7. Life Insurance Corporation of India
  8. Star Union Dai-ichi Life Insurance Co. Ltd
  9. Shriram Life Insurance Co. Ltd

Insurers are expected to publish the Sales Literature approved by IRDAI and adhere to the contents of the same. In case non-adherence is established Regulatory Action is initiated against the insurer.

The information sought is not available with the Authority.

The registration number of Life Insurers can be seen at the following link:-

www.irdai.gov.in  >> Consumer affairs>> List of registered entities>. List of Life Insurers.

The Life Insurance Products are governed by IRDAI (Non-Linked Insurance Products) Regulations, 2019 and IRDAI Linked Insurance Products) Regulations, 2019.The Regulations can be viewed on the Authority’s website i.e. at www.irdai.gov.in  >>Legal >> Regulations.

As per Regulation 14 (2)(i) of the IRDAI (Protection of Policyholders’ Interests) Regulations, 2017., the insurer may investigate the death claim. The regulation can be viewed at the following location in website 

Irdai.gov.in >> Legal >> Regulations >> 

IRDAI is empowered to issue Regulations as per section 26 of the IRDA Act, 1999.

No such rules are notified by the Authority in respect of Life Insurance. However, Life Insurers provide Insurance cover as per their board approved underwriting policies.

The information can be viewed at the following link:-

www.irdai.gov.in >> Reports >> Annual reports of the Authority

It can be viewed at the following link on the website of the Authority.
www.irdai.gov.in  >> Consumer Affairs >> Products offered >> Life Insurance products Terms and conditions
 

Nomination in a policy is governed by the section 39 of the Insurance Act 1938, which can be viewed at the following link on the website of the Authority.                www.irdai.gov.in >> Legal >> Legislations >.

Assignment in a policy is governed by the section 38 of the Insurance Act 1938, which can be viewed at the following link on the website of the Authority.                www.irdai.gov.in >> Legal >> Legislations>>

The surrender value of a Life Insurance policy is governed by the IRDAI (Acquisition of Surrender and Paid Up Values) Regulations, 2015. The Regulations can be viewed at the Authority website i.e. www.irdai.gov.in >>Legal>>  Regulations>>

Free look cancellation of Life Insurance Policy is defined in Regulation 10(1) of IRDAI (Protection of Policyholders’ Interests) Regulation,2017. The Regulation is reproduced below: -

“10(1). (i) The insurer shall inform clearly by the letter forwarding the policy to the policyholder that he has a free look period of 15 days from the date of receipt of the policy document and period of 30 days in case of electronic policies and policies obtained through distance mode, to review the terms and conditions of the policy and where the policyholder disagrees to any of those terms or conditions, he has the option to return the policy to the insurer for cancellation, stating the reasons for his objection, then he shall be entitled to a refund of the premium paid subject only to a deduction of a proportionate risk premium for the period of cover and the expenses incurred by the insurer on medical examination of the proposer and stamp duty charges.

(ii) In respect of a linked insurance product, in addition to the deductions under sub-regulation (i) above, the insurer shall also be entitled to repurchase the units at the price of the units on the date of cancellation.

(iii) A request received by insurer for free look cancellation of the policy shall be processed and premium refunded within 15 days of receipt of the request, as stated at sub clause (i), (ii) above.”

As per the IRDA (Non-Linked Insurance Product) Regulations 2013 vide circular ref: F.No. IRDA/Reg./13/71/2013  dated 16/2/2013 and IRDA (Linked Insurance Product) Regulations 2013 vide circular ref: F.No. IRDA/Reg./15/73/2013 dated 16/2/2013 the grace period for payment of the premium for all types of  insurance polices except single premium policies shall be;

  1. Fifteen days, where the policyholder pays the premium on a monthly basis.
  2. Thirty days, in all other cases.

The information on the PMJJBY scheme can be seen on the website of Govt. of India at the following link: https://www.jansuraksha.gov.in/FAQ.aspx

The guidelines for “Group Term Life Insurance” are laid down in  circular No: IRDAI/LIFE/MISC/CIR/172/09/2019  dated 26/09/2019 which can be viewed at the  website of the authority  under  

irdai.gov.in >> Legal >. Circulars >>  Life >.
 

The Regulations pertaining to group insurance can be viewed in Chapter VIII under Group Products in Insurance Regulatory and Development Authority of India (Non-Linked Insurance Products) Regulations, 2019. at the following link on the website of Authority. 

www.irdai.gov.in  >> Legal>>  Regulations >> Regulations >> Consolidated & Gazette Notified regulations >.

As per regulation 9(xviii) of Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests) Regulations, 2017. “The list of documents that are normally required to be submitted by a claimant in case of a claim under the policy” is stated in the life Insurance policy.

The information can be viewed at the Authority’s website  :

(1) Insurance Regulatory and Development Authority of India (Unit Linked Insurance Products) Regulations, 2019

www.irdai.gov.in  >> Legal>>  Regulations >> Regulations >> Consolidated & Gazette Notified regulations >.

(2) Insurance Regulatory and Development Authority of India (Non-Linked Insurance Products) Regulations, 2019

www.irdai.gov.in  >> Legal>>  Regulations >> Regulations >> Consolidated & Gazette Notified regulations >.

The Annual Report of the Authority can viewed at the Authority’s website at the following link:  www.irdai.gov.in > Report and Statistics >> Annual reports of the Authority.

The information is available on the site of the Council for Insurance Ombudsman at the following link  https://www.cioins.co.in/

Guidelines   on   Distance   Marketing   of   Insurance   Products  can be viewed at the following link.

irdai.gov.in >> Legal >> Guidelines >>

 

The Authority has not issued any Guidelines/Circular/rules regarding the eligibility to take term insurance or income/education/age criteria for availing term insurance. It is informed that the Life Insurers issue Insurance policies based on their board approved underwriting policy.

Policy not be called in question on ground of misstatement after three years” is dealt by Section (45) of the Insurance Act, 1938  which can be viewed at the following link on the website of the Authority at www.irdai.gov.in >> Legal >> Legislations>>

No separate law/instructions exist for term insurance claims rejection after 3 years.

The Authority has not barred any individual from buying or claiming any number of Life Insurance policies and from any registered Insurer with IRDAI. The benefit  in a life insurance policy depends upon the terms and conditions of the policy.

The information is available in Insurance Regulatory and Development Authority of India (Registration of Indian Insurance Companies) (Seventh Amendment) Regulations, 2016 which can be viewed  at the following section in the Authority's website . 

irdai.gov.in >> Legal >> Regulations >>