Kathmandu. KATHMANDU: The number of complaints filed at the Nepal Insurance Authority (NEA) in insurance claims is on the rise, especially from consumers. Not only consumer awareness, but also the tendency of the insurer to sell the insurance to the insured has led to disputes at the time of claim.
In most of the cases filed against the insurer, the decision of the quasi-judicial bench of the Authority in favor of the insured also makes it clear that the blame is more on the insurer than on the insured.
Insurance is a complex and technical issue. There are a number of conditions. There are many situations. There are some universally accepted theories. Non-risk situations are also included in the terms of the policy.
Non-life insurance also includes a condition that the insured has to bear a certain amount of damages. Life insurance has a waiting period. Under this scheme, the waiting period for children ranges from 30 days to 3 months in case of critical illness until they reach the age of 6 years.
If the insured does not understand these aspects of the insurance or does not try to explain it on behalf of the insurer, then the root of the dispute starts from here. And, eventually, when the claim is filed, the insured and the insured side turn against each other, and the case reaches the judicial body.
Many sell insurance policies to manufacturers. They don’t fully understand the terms. Important details such as the mentioned choices, the extent of the initial compensation, and the structures that are not included in the risk are overlooked at the outset. The insured tries to get insurance at the cheapest possible premium. In a competitive market, insurers also sell insurance policies that do not involve significant risk in order to avoid losing customers.
Professional honesty on the part of the insurer is to explain what risks have not been borne under the policy, in what cases the claim is not paid and why certain terms and conditions are important to a particular person or project.
In a recent example, the investors of the five-star hotel Hilton in Naxal took the insurance for granted. Its investors were fully aware of why they needed riot insurance. Because they themselves are the main investors of the reinsurance company. Due to the tendency to save the cost of insurance premium, the future of this hotel with an investment of Rs 8 billion is in uncertainty and doubts have been raised in the reconstruction.
Whether the insured inquires or not, the insurer or his representative is not a simple assurance, not a hasty answer, and certainly not ‘it will be fine’. Clear and precise guidance should be given.
Just because everything in the world is in our insurance market does not create trust between the insured and the insured. Only a simple explanation of the complex terms of insurance and the inquiries of the insured can build a foundation of trust.
