India’s general insurance business is
under a double squeeze of meager premium incomes and mega fire claims outgoes.
How it got trapped in such an unenviable position is symbolic of poetic
justice.
In the rudimentary stages, indemnity
was but the whim of the haughty loss assessor, as his fancy would suggest, that
the overawed insurers and the insured alike had to accept like a claim prasad. Though later on, the system had
acquired some semblance of balance, yet the irony of inequity, more or less,
remained the guiding factor for settling the claims of the small frays that
were treated like serfs in the general insurance corridors. More often than
not, owing to the insurers’ apathy, the claim processing was tortuous,
accompanied by arbitrariness, occasioned by their ignorance or suspicion, and /
or both. The hapless insured was hoodwinked to sign on the dotted line of the
discharge voucher, or else. Some claim processing officials even went to the
extent of maintaining dairies of their misdeeds, of coercive claim reductions, to
boast about the savings thus accrued to the company. Just the same, at the same
time, it was a red carpet, all the way, for the valued clients, more so when it
came to their large losses.
Strangely in those days, the
insurers’ penchant for celebrating large losses was indeed appalling in that the
normally staid offices tended to get agog with excitement to set the stage with
alacrity for hara-kiri. The search for an adept surveyor with a proven record
of handling huge claims used to begin in the right earnest, for co-option to
aid and abet in the instant case as well. Soon, with fervor to accommodate the
claimant’s demands, shared fervently by the ‘blessed’ surveyor, the claim used
to get tended on the settlement course with god speed. One may say, ‘whom gods
want to destroy they make mad’ but the general insurers’ genius envisioned an
underlying wisdom in this apparent madness of obsessive proportions; it was the
article of unwavering underwriting faith that publicity of generosity would
open up new premium vistas to usher in growth and improve the bottom-line.
However, in due course, this fond
hope, based on a false premise, lay shattered as it had to confront the
insatiable human greed that it fostered. Sadly thus, this insurance altruism,
pitted against the human truism, had in effect pushed the insurers into the
clutches of self-serving clientele, out to extract undue returns on the premium
paid. If anything, the advent of the consumer forums and more so the opening up
of the insurance business for the private sector, in the wake of the Malhotra
Committee’s report, made it worse for the public sector general insurers. So as
to stall the feared exodus of its harassed clientele to the private shores, the
only strategy that could be thought of by these uninformed white-collars was client
appeasement. Thus, in a great maneuver of a grand U-turn, client satisfaction,
above all else, became the buzzword in the public sector general insurance
corridors. Client satisfaction could have been, as well, achieved through
timely claim settlement, capping indemnity with a sop or two to propitiate the
greedy, if need be, but then as balancing
things had never been the public sector virtue, inevitably, the profound
philosophy, in practice, came to be interpreted as a license to appease, to
fashion client satisfaction. And that was that.
Once the hounded turned into the
hunter and the harasser became the harassed, the naivety of the knee-jerk
reaction for self preservation blew up in the public sector faces. With the
“I’ve preferred a claim, so you better cough up” stance, the clientele began to
coerce the flummoxed insurers on the specious ground “Never mind the fine print
about the liability or lack of it”. What if the claim is even made up? The
clients have upped the ante and the insurers had no alternative but to give in,
but in the end, perhaps, poetic justice catches up regardless.
But nothing tilted the balance of
attrition like managerial expediency to circumvent the constraints of, what may
be called, the archaic ‘car-phone’ rule by which only the personnel manning the
business line of operations, but not those maintaining the administrative
edifice, were entitled to these modern day necessities, attached though with
status and prestige in the then developing Indian society. So as to let the
teeming new breed of directly recruited administrative officers, who have come
of age in the set up, to lay their hands on the car steering and the telephone
receiver at home, they were made branch and division heads, so to say, without
any screening or training.
However, given that marketing is a
different cup of tea; even as most of the new marketing novices turned out to be
misfits, yet the managements tasked them to expand the premium base under their
control. Given that the public sector has always been averse to the profit
centre concept of administration for the fear of being exposed to its
managerial inadequacies, these ‘new heads’ in the branches and the divisions
found it expedient to acquiesce as a
policy of retention of the client base, making it a case of digging one’s own
grave! Thus the only growth these could show was in the form of largesse to the
claimants resulting in ever increasing underwriting losses, which coupled with
the disproportionate operating expenses, made these enterprises look at the
barrel. And that does not make a good business copy, even for the public sector
companies! But, yet the delusions remain in the managerial chambers, it would seem
so.
It is into this crooked scenario, the
private insurers had ventured into, as it turned out, to make it murkier. One
hoped that the private players would reach out to the uninsured multitudes of
small traders, householders, and such to bring them under the underwriting umbrellas
for mutual benefit. But sadly, they chose the easy way out, of poaching the
existing clients from the public sector insurance folds through means that were
often not above the board. What was worse, in their eagerness to seem apart
from the lethargic public sector, when it came to claims settlement, they took
to the fast track of claim settlements, oblivious of the high moral hazard of the
Indian business ethos and the fact that fire claims are too complex for ready comprehension.
If ever they undertake an indemnity audit, they would come across many a
hillock and varied mountains of over indemnity, underscored by ‘haste is waste’
adage.
Now the moot point is, are the
general insurance underwriters prepared to have a second look, for their own
good. For every claimant spoilt with doses of over indemnity, millions of
clients are likely to suffer if the bubble bursts. This underlying duty for the
larger good should override the narrow desire to please the overbearing, for
achieving sectarian ends. It’s fine to treat the customer as god but should the
devil itself choose to don god’s garb, expedience lies in exorcising it. Let it
be deliberated before the point of no return is reached as the Frankenstein
monster devours its masters. As and when the ugly saga comes to an end, on its
ruins may be laid the level playing fields of general insurance - for the
insurers and insured’s alike.
And that brings to the fore the role
of the surveyors and loss assessors in this sordid episode. For the surveyor,
it is one thing to handle a large loss, any loss for that matter, and another
to hand out largesse. However, as the public sector eyes, long enamored as they
are with large losses, failing to discern this vital difference, historically
promoted the charlatan surveyors and cold shouldered the professional loss
assessors. If anything, the degeneration in the recent past virtually ensured
that surveyors donned the role of go betweens, further marginalizing the
professional minded amongst them. The question that naturally arises is, how to
bring the general insurance sector to the even keel of indemnity by weeding out
the over indemnifying surveyors and ushering in a band of equity loss
assessors. But there’s a hitch in that the remuneration to the surveyors is
directly proportional to the loss assessed by them and though that tends to
abet over indemnity, the insurers have turned a blind eye to this debilitating
aspect.
Whatever, only true professionals can
bring parity to indemnity, but how to spot them in the milieu? Here are some
basics to the insurers in first person.
One cannot go by their smooth talk or
hard sell, for sure. Knowing their approach and attitude should help, to start
with, before character and competence come to be judged. Rudiments of human
psychology could provide pointers to the insurers on the way of professional
selection. If the chap on the other side of the table sounds ingratiating with
you, it may satisfy your ego, but what about your interests? It’s okay with
public sector officialdom allowing itself to be played up to, but surely
private company managers have a stake in the way things shape up under their
command. How those who are prepared to humor you, for an assignment or two,
fare with the claimants, with inducements on hand, out to grind their axes on
the wheel of over indemnity? It’s anybody’s guess. Isn’t it?
But the professional self-worth
operates on a different plane. It seldom crosses the threshold of nice talk. A
professional could be the right bet as he is the one, more unlikely, to play
ball with the claimant to your detriment. Be wary if the surveyor eulogizes the
claimant while briefing you or writes his biography in his survey reports. For
sure, he could have allowed himself to be overawed by the claimant and thus
would have lost his ability to judge issues objectively. On the other hand, a
professional, tries to focus on the job on hand, and has no interest in the
personalities associated with it. Thus, his judgment is more likely to be sourced
in equanimity.
Beware of the fellow who tends to
brief you about the claim in great detail beforehand. You may feel that you are
being kept in the claim loop but in effect you are being influenced, willy-nilly,
to see things the way he wants you to see them. You had already lost your
ability to judge even before the case comes up for your scrutiny. Remember the
adage - we learn best by doing, next by reading and worst by listening.
Bu the professional provides you with
the best option you have, since you are not expected to carry out the survey
yourself, anyway; he gives the picture in writing, for you to read and
comprehend it for yourself. That is, if you are prepared to read. In the public
sector portals, barring exceptions, it is listening that prevails at the
decision making levels, and the survey reports are treated as mere post scripts
of the claims! Laziness to go into details costs, even more than, eye for
detail that anyway is much scarce. But it is the other way round with the
surveyors in the existing order.
It is the paradox of the survey
profession that efficiency doesn’t pay that is owing to the linkage of
remuneration to the indemnity. The more diligent a surveyor in rationalizing
the insured’s claim, the lesser he earns as remuneration for his diligence. Contrarily,
owing either to naivety or motive, if the surveyor fails to call he claimant’s
bluff, he gets paid all the more for the lack skills or more. It’s another
matter that the insurers end up paying through their noses for the unwarranted
ways of the surveyors. Thus, for the easy go lucky surveyor, the starting point
of the survey is the claim amount projected by the insured, and for the sake of
form, it is to be downsized as is imperative in the insurers’ eyes. The charlatans
of surveyors, to that end, enter into a half-hearted bargain with highly
motivated claimants, out for a kill. If the claimant were unrelenting to yield
some ground, the surveyor would go on his knees even, to extract concessions,
to accord credibility to his assessment. The merciful gesture of the claimant
is then sealed in a “consent letter” to be flaunted by the surveyor as a
“certificate of achievement” in the corridors of the gullible underwriters. The
insurers, for their part, feel beholden to the surveyor for the “love letter”
that bodes well for an easy working day. The spirit of reciprocity ensures that
the surveyor gets hailed for having handled the claim well, to be assigned more
claims to let him hand out more losses for a hassle free handling for
themselves.
However, for the professional
surveyor, who doesn’t put the cart before the horse, it is a hard grind all the
way. Thus, for professionalism to thrive in the survey filed, the surveyors
ought to be paid for the rendered services, on the scale of intricacy and
contribution, and not for the largesse bestowed upon the claimants. What
distresses even more is that the underwriters keep no track record of the
surveyors in exposing the claims of fraudulent nature. Needless to say, fraud,
whenever attempted, should be exposed and the claim repudiated regardless of
everything. After all, does not fraud negate the very concept of utmost good
faith of a contract of insurance? Yes, it does, but suspecting a fraud is
different from effectively closing in on that to shut it out is a different
ball game.
However, the prevailing norm is for
the surveyor to air apprehensions in the insurance corridors that is whenever a
claim is beyond his comprehension. The insurers for their part, what with their
suspicious having been raised, run for the cover and an investigator would be
put in place. Once the detective is in, the surveyor relaxes, and the insurers
feel relieved, having passed on the buck. When the investigator finally hands
out a clean chit or comes up with no evidence, everyone falls in line, though with
their suspicions intact, to reward the fraud. Occasionally, a claim is
repudiated on a gut feeling or based on insufficient evidence only to come a
cropper in the courts of law.
In the superficial work culture
nurtured by lethargy and semi intellect, it doesn’t occur to any that the means
to expose frauds are packaged in the insurance policy itself, and that the
process to pin the sin is part of a survey. In case of the Fire Policy, for
example, conditions No 6 and 8 together provide the necessary leverage to
effectively close in on a fraud claim provided the surveyor has the will and
the wherewithal for that. Nevertheless, as a rule of thumb, fraud should be
writ large on the claim in many a case.
It should be realized that the
instinct and the acumen required to repudiate a claim, either in full or part,
far outweigh the effort and skills that go into the loss assessment. But the
general insurers remain unconcerned about it when it comes to remunerating the
surveyors for such repudiations, making it a thankless job for the latter. What
is worse, the surveyor is perceived as the one who had spoiled the party and
branded as such to be bypassed for further assignments.
Since it has been proved that claim
equity is beyond the means of man, only the Fire gods, Agni and Hephaestus, can save the Indian
general insurance from over indemnity by not giving cause for loss at all, if
not, very scarcely.