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Insurance Cos Impose Certain Norms On Agents

Monday, August 25, 2014
By Manoj Aswani

Manoj Aswani is VP at MyInsuranceClub.com

I am confused between MaxBupa and Apollo Munich can you help me on which one I should go for? I want a cover for myself (age 44) and my wife. I want comprehensive and maximum coverage and no * and strings policy so that I can renew for life and it should take care of all my medical exigencies... any suggestion would be of great help.
—Raja Puri, Parel
Both Max Bupa and Apollo Munich are very good options and most policies in both these companies can be continued for life.

You can surely consider Apollo Munich Easy Health Premium Plan which can be taken till Rs 50 Lakh of coverage. The list of benefits would be:

Benefits

  • Inpatient Treatment
  • Pre-hospitalization
  • Post-hospitalization
  • Day-care Procedures
  • Domiciliary Treatment
  • Ayush Benefit
  • Daily Cash for choosing shared accommodation
  • Expenses for Organ Donor
  • Emergency Ambulance
  • Daily cash for accompanying an insured child (less than 12 years)
  • New Born Baby
  • Maternity expenses with waiting period of 4 years
  • Outpatient Dental Treatment with a waiting period of 3 years
  • Spectacles, contact lenses and hearing aids every third year
  • E-opinion in case of critical illness
  • Additional cover for Critical Illness
  • Health Check-up

I am an LIC agent since August 1993. For many years I have done minimum business requirement. However, this agency year I have not done any business. Kindly inform me now whether I will get exemption from LIC for doing minimum business?
—Sachin Singh, Parel

It totally depends on the LIC Branch you are associated with. According to an internal policy of LIC, there is a Minimum Business amount that an agent needs to do every year to retain his agency.

According to the rules of LIC, you need to do at least:

  • 1st year- Minimum 6 lives and Rs 50000 FPI
  • 2nd year- Minimum 6 lives and Rs 50000 FPI

By the end of the 3rd year, you need to do a Minimum 36 lives and Rs 3 lakhs FPI cumulatively in the last 3 years.

If the above conditions under "Minimum Business Guarantee" or MBG, your license would get terminated via a letter from the HO. However, the same can be reinstated by the Branch Manager in the 4th year after license expiry. But even in the 4th year, if you are unable to do the MBG or at least 12 lives or Rs 1 Lakh of Premium, then your agency would get permanently terminated.

There's no such rule as per IRDA but the insurance company or the branch may impose certain norms. Renewal commission would be payable since you have completed 5 years in the company even if you do not do even 1 policy as per IRDA.

I have an Aviva Life Shield Platinum (offline) 50L purchased in 2010. I am planning to take another 50L through Aviva I life (Online). I have checked many websites/ experts panels they say Aviva is having only 89% claim settlement ratio. Should I go for some other better insurers? My concern is would it be better if I have a policy with the same insurer?   
—Ganesh Yadav, Parel
It’s not that you must go with other insurance company only because the Claim Settlement Ratio is lower in Aviva. In fact, you must only concentrate to state loads of correct facts in your proposal form irrespective of the Insurance Company you are applying for. If you do not state the truth at the time of policy inception, then even if the Claim Settlement Ratio of the company is very high, you might not get your claim settled as there is misrepresentation or non- disclosure of material facts.

On the other hand, if you disclose all correct information at the time of policy inception then even if the claim settlement ratio is bad, your claim will get admitted.

As far as your case is concerned, operationally it will be easier since you have only 1 insurance company, claim admitted will be operationally easier. So, yes your decision makes sense.

(The author is Vice President at www.MyInsuranceClub.com, insurance comparison website in India. You may write to him at [email protected])

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