m. ramadoss chairman-cum-managing director [email protected] non-performance: an...
TRANSCRIPT
IMPORTANCE• One of the prime causes for the entry of
private sector in the industry is to throw the industry open to competition from several players
• Competition is expected to bring in the best in the industry, bring in the best terms for the customers
• Remember the Rs.28 per “incoming” call charged by Mobile phone Companies or the Rs.25000 one-way airfare to Singapore!!
WHAT IS CUSTOMER SERVICE?
A business cannot exist unless it has customers to buy the products it wants to sell. Customer service is the term used to describe what happens at the points at which the customer comes into contact with
the business.
CUSTOMER SERVICE CIRCLE
CUSTOMER EXPECTATIONS
IN GENERAL INSURANCE,
CUSTOMER EXPECTATIONS
ARISE AT TWO STAGES
1. POLICY SERVICING STAGE
2. CLAIMS SERVICING STAGE
POLICY SERVICING
POLICY SERVICING
• INFORMATION STAGE
• ENLISTMENT STAGE
• POLICY SUPPORT STAGE
• SECONDARY SERVICES
INFORMATION
PROSPECTS NEED ADEQUATE INFO ON COVERS, TERMS AND RATES TO ENABLE THEM DECIDE THEM THE NEED FOR INSURANCE, THE TYPE OF COVER, THE RIGHT AMOUNT
NEED FOR BROCHURES, PAMPHLETS, KNOWLEDGEABLE INTERMEDIARIES
INSURER’S REPUTATION AND IMAGE SHOULD INSPIRE CONFIDENCE
‘HELP DESK’ FOR PROVIDING COVER INFORMATION
ENLISTMENT STAGE
SEVERAL PROSPECTS REQUIRE ASSISTANCE IN DOCUMENTATION LIKE FILLING UP PROPOSAL ETC.
ENLISTMENT SUPPORT BY INTERMEDIARIES SHOULD BE DONE WITH CARE AND ONLY WITH FULL CONCURRENCE OF THE INSURED HIMSELF
POLICY SUPPORT STAGE
• SATISFACTION OF FAIRNESS IN THE DEAL
• SPEED OF DELIVERY OF DOCUMENTS
• CORRECT POLICY DOCUMENT – CONSENSUS-AD-IDEM
• EXPLANATION OF THE POLICY DETAILS WHERE REQUESTED BY CUSTOMER
SECONDARY SUPPORT STAGE
INCLUDES POST POLICY SERVICES SUCH AS
ENDORSEMENTS
ALTERATIONS & ADDITIONS
CANCELLATIONS
INTERMEDIARY ISSUES
• AGENTS/ BROKERS OVER-SELL & INSURERS UNABLE TO MEET THE CUSTOMER EXPECTATIONS
• INTERMEDIARY PROPROTIES ARE DIFFERENT FROM COMPANY’S PRIORITIES – EXAMPLE MEDICAL POLICIES FOR AGED PERSONS
CLAIMS SERVICING
CLAIMS SERVICING
• THE CORE OF CLAIMS SERVICING IS– ‘HELP DESK’ FOR IMMEDIATE RESPONSE– TRANSPARENCY OF ASSESSMENT– SPEED OF SETTLEMENT OF CLAIMS– LEAST DISTURBANCE / INCONVENIENCE
TO THE CUSTOMER– FAIR AMOUNT OF SETTLEMENT
CLAIM ASSISTANCE
• CUSTOMER BE TREATED WITH CARE & UNDERSTANDING AND NOT WITH SUSPICION & DISTRUST
• SURVEYOR COMPETENCY IS VITAL
• ALL REQUIREMENTS TO BE LISTED IN ONE GO
• SYSTEM OF ADMISSION OF LIABILITY
INTERMEDIARY ISSUES
• SURVEYORS SHOULD SUBMIT REPORTS WITHIN TIME FRAMES
• REQUEST FOR DOCUMENTS/ INFORMATION SHOULD BE IN WRITING
• ASSESSMENTS SHOULD BE FAIR AND TRANSPARENT
• DISPUTED ISSUES TO BE BROUGHT TO THE URGENT KNOWLEDGE OF INSURER
CLAIM SETTLEMENT
• IF SETTLEMENT AMOUNT IS DIFFERENT FROM THE CLAIMED AMOUNT, FULL REASONS FOR DIFFERENCE TO BE GIVEN TO INSURED
• IN CASE OF REPUDIATION, CLEAR REASONS FOR REJECTION TO BE GIVEN
• INFO ON APPEALS & GRIEVANCE REDRESSAL
PERFORMANCE APPRAISAL
OF INSURERS
HOW HAVE WE PERFORMED?
• CREDIBILITY OF INSURERS – A NON-ISSUE
• ALL INSURERS HAVE SOME SYSTEM OF TECHNOLOGY FOR QUICK ISSUANCE OF POLICIES, BUT DELIVERY BACKLOG STILL PERSISTS DUE TO ADMN ISSUES, POLICY STAMPS ETC
• DEFINITE GAPS IN CORRECTNESS OF THE POLICY
PERFORMANCE IN CLAIMS SERVICING
• LACK OF EMPATHY OR EVEN SYMPATHY• CUSTOMER IS NOT CLEAR ON ACTION TO
BE TAKEN IN THE EVENT OF A CLAIM• DELAYS IN EVERY STAGE EVEN IN
APPOINTING SURVEYOR• SURVEYOR INCOMPETENCIES –
BARGAINERS AND NOT LOSS ASSESSORS• CLAIM OFFER LETTERS DO NOT DISCLOSE
BREAK-UPs
CUSTOMER SERVICE BALANCE SHEET
ORIENTAL FOR INSTANCE ISSUED ABOUT 1 CRORE POLICIES AND HANDLED 6 LAKH CLAIMS DURING 2005-06
TOTAL NUMBER OF GRIEVANCES LESS THAN 5000 WHICH IS 0.04%
EVEN THIS HAS TO BE REDUCED
NON-PERFORMANCE
• GENERALLY, ONLY MOTOR AND HEALTH GIVE RISE TO GRIEVANCES
• MOST GRIEVANCES RELATE TO DELAY IN SETTLEMENT/ REJECTION
• VERY FEW COMPLAINTS ON RUDE BEHAVIOUR OF EMPLOYEES
• UNDERWRITING GRIEVANCES ARE VERY VERY FEW
NON-PERFORMANCEHEALTH
• PRE-EXISTING CONDITONS
• TPA IS NON-RESPONSIVE TO URGENCY
• BREAK IN INSURANCE
• REQUEST FOR COVER FOR OLDER PEOPLE
• HIGHER PREMIUM CHARGED BASED ON AGE
NON-PERFORMANCEMOTOR
• ACCEPTANCE OF OLD VEHICLES
• RENEWAL OF COVERS WITH HIGH CLAIMS RATIOS
• DL/RC VERIFICATION & INVESTIGATION
• SALVAGE VALUATION IN CASH LOSS
• DEPRECIATION AND DENIAL OF CERTAIN PARTS
FUTURE EXPECTATIONS
1. E-INSURANCE: POLICIES ON INTERNET/ ATM
2. POLICY/ CLAIMS HISTORY AND STATUS ON INTERNET
3. TRANSACT SIMPLE POLICY RENEWALS OVER INTERNET WITH CREDIT CARD PAYMENT OPTIONS
4. M-INSURANCE: TRANSACTIONS THROUGH MOBILE PHONES
FUTURE EXPECTATIONS
5. INTEGRATED HEALTH INSURANCE WITH PREMIUM DEDUCTED AT SOURCE- SOCIAL SECURITY CHIP CARD WHICH WILL ALSO ASSIST IN CASHLESS CLAIM FACILITY
6. HASSLE-FREE MOTOR CLAIM SETTLEMENT AND STANDBY VEHICLE DURING REPAIR PERIOD
7. ONLINE CLAIM INFO & COMPLAINT TO OMBUDAMAN & CONSUMER FORUM
SOLUTIONS?
• CUSTOMER EDUCATION BEFORE SALES
• REGULAR CUSTOMER EDUCATION PROGRAMMES TO FEED UPDATED INFORMATION PERIODICALLY
• FULL USE OF IT IN UNDERWRITING AND CLAIMS
SOLUTIONS TO INTERMEDIARY PROBLEMS?
• FULL CONTROL ON APPOINTMENT OF SURVEYORS
• MONITORING SURVEYOR CORRESPONDENCE WITH INSURED
• TPA PERFORMANCE TO BE MORE CLOSELY MONITORED
• RUTHLESS PRUNING OF INTERMEDIARIES
SOLUTIONS?
• EMPATHY TRAINING FOR EMPLOYEES• IMMEDIATE DECISION ON ADMISSION OF
LIABILITY• ENCOURAGE PRACTICE OF ‘ON ACCOUNT’
PAYMENT• REGULAR REVIEW OF PENDING CLAIMS• PERIODICAL ENHANCEMENT IN FINANCIAL
AUTHORITY FOR CLAIMS PAYMENT• COMPULSORY PAYMENT OF INTEREST ON
DELAYED CLAIMS
CUSTOMER FAULTS• SOME TIMES CUSTOMERS
ALSO ARE AT FAULT– NOT RESPONDING TO
REPEATED REQUESTS– FRAUDULENT
INTENTIONS– IRRITABILITY – why ask
all these unnecessary questions?
– EXAGGERATED / INFLATED CLAIMS
– LACK OF UNDERSTANDING OF POLCY COVERAGE
INSURER’S RATIONALE
THERE IS NO EXCUSE FOR
NON-PERFORMANCE
EXCELLENT SERVICE IS LIKE HORIZON. THE NEARER YOU GO TOWARDS IT, THE
FARTHER IT GOES AWAY FROM YOU!!!!
WE ARE FAR AWAY FROM 100% CUSTOMER SATISFACTION AND MILES TO GO EVEN
BEFORE WE THINK OF SLEEPING
THANK YOU