Insurance Regulatory and Development Authority (IRDA), insurance market watchdog has issued draft regulations for Orphan Policies.
Introduction:
Insurance agents are the most important channel of intermediation in
the insurance business in India. Recognizing the importance of the
agents in the procurement and servicing of insurance policies, the
Insurance Act has two specific provisions, namely Section 40(2A) and
Section 44 which protect the long term interests of agents. In brief,
under provisions of Section 40(2A), lapsed policies which require
medical examination prior to revival can be assigned to another agent
after giving due notice to the existing agent to revive such policies.
In such cases, new agent is entitled to commission of only 50% of what
the procuring agent would have been entitled had the policy continued to
be in force. Under Section 44, except on grounds of fraud, an agent who
has served an insurance company for a period of 5 years shall be
entitled, subject to certain conditions, to renewal commission on such
policies if he discontinues his agency. However, agents who have
completed 10 years of service with a given insurance company and stops
for any reason his/her agency business but does not join another company
are entitled to renewal commission on all such policies which they had
placed. The commission on policies covered under Section 44 is
inheritable and entitled to be passed on to the legal heirs of that
agent.
2. In the evolving Indian
insurance context, it is noticed that a large number of agents
discontinue services with a given insurance company before completing
the minimum service prescribed. During the period of their service with a
company they would have placed some policies and on the discontinuance
of an agent such policies are left “orphan” and the policyholder suffers
from lack of proper assistance in the servicing of the policy. The
insurance company also suffers because of the drop of persistency which
might occur in such cases. Given this pattern, IRDA believes it is
important and in the interest of such policy holders to provide for a
system where they are not denied the benefit of having an agent to look
after their policy service issues in the best interest of policyholders.
3. In order to address this gap
created by exit of insurance agents well before attaining qualifying
criterion as stipulated in Section 44, the Authority proposes to issue
the following guidelines:
Guidelines on Servicing of Orphan Policies
1. ‘Orphan life insurance policies’ for
the purpose of these Guidelines, means the policies initially effected
by an insurance agent whose services were subsequently terminated or
removed from the rolls of the insurer excluding those policies to which
the effecting agent is entitled to renewal commission under provisions
of Section 44 of the Insurance Act. The policies that are considered
eligible under proviso to section 40(2A) of Insurance Act also do not
fall under the purview of this definition.
2. “Allottee Agent”
for the purpose of these guidelines is an individual insurance agent
who is on the rolls of the life insurance company to whom the orphan,
lapsed life insurance policies are allotted for the purpose of
conservation and rendering the policy services.
3. ‘A lapsed life insurance policy’
for the purpose of these guidelines is a policy on which premium that
is due and remained unpaid even after six months from the date of first
unpaid premium.
4. Insurance
companies are allowed to allot any of the lapsed and orphan life
insurance policies to individual insurance agents whose license is in
force for the purpose of conservation and rendering effective policy
service to the policyholders. Only a life insurance policy that is in
lapsed condition on the date of allotment is eligible for allotment.
5. Single
Premium Life Insurance policies or life insurance policies on which no
further premiums are due for payment (Limited Premium Payment Policies
after the expiry of Premium Paying Term) are not eligible for allotment
under these guidelines. Life Insurance Products designed with specific
marketing features, inter alia, say direct / online marketing where no
commission outgo is projected under respective File and Use are also not
eligible for allotment.
6. The Life Insurers shall notify the particulars of ‘Allottee agent’to the concerned policy holders.
7. The
‘Allottee agents’ shall be provided a list of such allotted life
insurance policies along with the addresses for policy servicing. While
submitting the list, it shall be stipulated that the purpose of
submitting the said list is for rendering required policy services and
any details thereof shall neither be parted with to any third party /
entity nor be used for any other business purposes. However there is no
bar in an ‘Allottee agent’canvassing new policies to the policyholder
after reviving the lapsed allotted policies.
8. It
shall be specified to the ‘Allottee agent’ that the objective of the
allotment is the conservation/revival and further servicing of the
policies.
9. Regulation
8 of IRDA (Licensing of Individual Agents) Regulations, 2000 (Code of
Conduct) applies to the ‘Allottee agent’ in respect of all the allotted
policies. It shall be disclosed upfront to the Allottee agent.
10. While
allotting the policies for servicing, the life insurers shall direct
the Allottee agents that all policy services shall be rendered similar
to how an insurance agent would render to those policies that were
otherwise effected by him / her.
11. The
insurers are allowed to pay the following remuneration to the Allottee
agent towards policy service in respect of the policies allotted to
him/her
a. Equivalent to the commission rates mentioned in the respective File & Use.
b. The
remuneration referred in 11 (a) above is payable only on revival of a
lapsed orphan policy on account of arrears premiums received on or after
the date of allotment and also on subsequent renewal premiums paid
under the policy.
c. No upfront / advance payments are allowed on account of the policy allotments referred herein.
d. The payment of remuneration shall cease with the exit of an Allottee agent by any means and such Allottee agent will not be eligible for the benefits accorded by 44 of the Insurance Act.
12. The policies that are allotted for servicing shall not be counted for persistency of the Policy allotted agent.
13. The
allotment of lapsed policies shall be done judiciously by the life
insurers keeping in view the ability / feasibility of the insurance
agents to service the policies allotted.
14. Insurers
shall also take in to account the track record of the agent and
complaints registered against an agent etc. while allotting the orphan
policies.
15. The
Life Insurers shall take an undertaking from the agents regarding their
willingness for the proposed allotment and their consent for rendering
the required policy services.
16. Where
a lapsed policy allotted is not revived / reinstated within 3 months
from the date of such allotment, life insurers shall have the discretion
to undo the allotment by issuing a formal notice to the Allottee agent
and re-allot to any other agent as per the norms prescribed herein.
17. An
allotted policy which was revived or reinstated but lapsed subsequently
may also be allotted in accordance to the provisions of the within
referred stipulations.
18. Allotting the lapsed policies by a life insurance company is only an option.
19. The
Insurers shall put in place procedures for capturing the details of the
Policy allotted agents who are servicing the allotted policies, in
order to ensure that the objectives of allotment are met.
Comments if any on the above exposure draft may be forwarded to the following before 31st March, 2012.
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