When the moment of truth arrives …

The insured pays (in terms of premium) to the insurance company for years and expects benefits only when he/she faces the unfortunate event of a claim incident. Claim benefit thus becomes the core value proposition that an insurance company offers to the insured. Not only is the promise to service a (genuine) claim, a legal contract between the insured and the insurer; it is also a social and moral responsibility of the insurer. An insurer's reputation too is at stake while dealing with claims and its processing. Insurer's imperative therefore depends on how it processes the claim in a prompt manner and minimizes repudiation of genuine claims. Industry and its players have rightly been monitoring some of the key parameters like claim repudiation ratio, claims ratio, claims process TATs and claims related complaints as indicators of health of the claim function. However, ensuring claim function effectiveness is not a one-sided responsibility. There are often challenges from the customer side too ( e . g . frauds , incomplete understanding of insurance converge, unreasonable claims) which make the claims experience a not so pleasant one. It is therefore fair to say that to improve the core value proposition of insurance business – the claim experience, both – the insurer and insured, need to contribute across the entire value chain of the process. The benefits from such efforts are high and mutual (for the insurer and the insured).o