INSURED at risk with the IRDAI proposed SURVEY REGULATION 2019.
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IRDAI – Insurance Regulatory Development Authority of India has published an ‘Exposure Draft’ on Draft Surveyor Regulations, on its website www.irdai.gov.in calling for opinion from public and stake holders. It is observed that there is a flurry of activity in press (print media) and visual media, about the effect of such regulations, claiming to be authorizing the policy holder for self assessment of their own claims, and shall result in speedy claim settlement, as Surveyor is not required to be appointed for claims upto Rs.75,000 for Motor and Rs.1,50,000 for Non Motor claims. Such expression is just out of scope or nonexistent in the said draft regulations. Here, it is to bring to the notice of insuring public and other stake holders that in fact the delay in settlement is not due to Surveyor; but due to repair time taken by the workshop, and the process of settlement in the Insurance Co.
SLA – Surveyor and Loss Assessor in insurance industry is an intermediary, and is not aligned to either party to insurance contract, and not an employee; as per an earlier (2012) exposure draft, and website declaration of IRDAI. SLA is an entity licensed by IRDAI, formerly by Controller of Insurance. This profession has developed over the decades, as freelance nature invited multiple talents from various fields chose this as a profession. IRDA promoted a body ‘IIISLA’ – Indian Institute of Insurance Surveyors and Loss Assessors, which is in existence since 2005. IIISLA has 3 nominee Directors, 1 from IRDA, another from Ministry of Finance, Govt. of India and Chairman, GI Council as ex-officio Director. Thus the policy making as far as loss assessment in respect of claims against insurance policies in general insurance industry, is in the hands of IIISLA, which has the technical talent with proper and responsible governance in place. IIISLA was modelled on the lines of ICAI, ICSI and the like professional organizations, the membership of which is mandatory to function as SLA.
It is essentials that all the claims are brought within the purview of the SLA profession, for ensuring proper and just indemnity to the policy holder besides having a balanced approach as to the cost control of claims, by identifying the inflated and fraudulent claims.
IRDA is authorized to make Regulations in respect of SLA profession, and they have made such regulations in the year 2000, 2013, 2015 and presently 2019. If these are examined, we find that there has been no consistency or any rationale of approach in formulation of such regulations. In the year 2000, the SLAs were graded as A, B, C with a review provision for up gradation from to time, which never took place. In 2013 regulations these grades of A, B, C were sought to be replaced with membership level of IIISLA. Now, the regulations seek to do away with membership level of IIISLA, and propose new set of gradation of Surveyors as Individual, Corporate and Employee. Thus the regulations by IRDA jumped lanes and there has been no effort to follow any road map or a path of pursuance of a set objective.
Amended Act 2015 stipulates that to be SLA, one needs to (i) possess qualifications prescribed by the Authority in the Regulations made under the Act and (ii) shall be a member of IIISLA. But the draft Regulations 2019 prescribes the gradation of SLA, overriding / ignoring / neglecting the Act itself. This act of the Regulator is totally unethical, as the Act made by the Parliament cannot be overlooked by an Authority, which was created by the same Act.
The neutrality role of SLA is sought to be compromised citing costs and speed of settlement of claims, without any justification or back up / substantiating data or information. The speed of settlement when Surveyor is not involved is false, and the cost of Surveyor is a miniscule % of claim amount. In a similar set up of health insurance all the claims are handled by TPA, and there is no ‘No TPA’ limit; and TPA gets a fixed % on every policy, while the SLAs get assignment based fee (and not on every policy). Thus the basis on which such Regulations are drafted and published as Exposure draft by the Regulator, have no legs to stand.
The complexity and inappropriate nature of the Regulations can be understood from the provision that once the license (a non-requirement post amended Act 2015) is issued by the Authority, the membership of IIISLA is automatic and can’t deny membership. IIISLA, which is sought to be made as SRO (Self Regulatory Organization like ICAI) for the SLA profession; is now sought to be made a fee collecting agency. This act of the Regulator is highly objectionable and we feel humiliated at such derogatory provision even at the draft stage.
(i) Stop considering Employees of Insurance Cos. from SLA functions; to eliminate 'conflict of interest' in the loss assessment.
(ii) Facilitate providing service of SLA to ALL claims, irrespective of quantum of claim.
(iii) Allow IIISLA to devise and implement its own criterion for admission of Members, considering the 'fit & proper' aspects, besides qualifications prescribed by the Authority in the Regulations made under the Act.
(iv) Empower IIISLA with ALL data related to ALL claims, to develop proper analysis and devise ways and means of loss minimization, and standardization of Loss Assessment and Adjustment practice.
(v) Strengthen IIISLA by providing needed infrastructure to develop research facilities, crash analysis, forensic facilities of analyzing losses; to enhance service levels to the Industry.
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