–Refusing to pay claims without conducting a reasonable investigation
–Not attempting to provide prompt, fair, and equitable settlements
–Offering lower settlements to compel insureds to institute lawsuits to recover amounts due
This is taken from the text book that I use to teach Risk Management & Insurance at a local university.
Tan Kin Lian
6 comments:
Dear Mr Tan
It would seem that;
1. the textbook is wrong
2. the claims officers are incompetent (don't know their job)
3. management may have inappropriate KPIs set on the claims officers that is not aligned with what the textbook teaches
Whatever the case, it is undeniable that a lower level of successful claims will help boost the profits of an insurance company.
Which was why I used to think very positively about NTUC Income since it was a cooperative.
I guess times change. If we can't beat the robber barons, it's time to join them and learn to become financial gangsters ourselves.
But always under the protection of the law and business friendly government policies.
The insurance companies know that this is one area they can reduce the operating cost so that more can go to pay the ceo and the senior management and the agents.They are cheats and they are in this business to cheat the unwary consumers using the greedy agents to execute the plans.
I guess it is standard procedures for claim officers to simply brush aside a claim in the first instance without looking at its validity.
This is just to buy time and get a response from the claimant first.
After that they will look into "loopholes" and "weak points" from the Claimant's statement of claim to contest the validity even though they may think that there is an element of validity.
If they get a stronger response from the Claimant after that, they will then try to settle out of "goodwill" etc.
My advice is if the claim is strong, file a police report if these inconsiderate claim officers tried to "play" with the claim. They may be trying to portray that they are "hardworking and knowledgeable" infront of their bosses while taking advantage of the layman who lacks common knowledge, though they may be taking risk by ignoring their duties and responsibilities.
Major factor of insurer's profitability depends on the claims experience. So it is no surprise that major KPI for claims officers is to minimise claims payouts. Once when your job security, promotion aspects and salary depends on a certain outcome, humans will then behave accordingly.
It is the same with govt's obsession of GDP as the prime KPI -- even to extent of basing their annual bonuses on GDP figures. As Singapore's GDP is moderating due to maturing economy and with the hollowing-out of traditional manufacturing, the govt now is planning to use GNP as the main KPI instead.
Do the textbooks say anything that only insurance agents can claim on behalf of the policyholders.? NTUC agents seem to think so that without them it is very hard or cannot claim.
Without the agents the claim department won't entertain and take their time and play a fool.So buying direct has this disadvantage.
Dear Mr. Tan:
I had a NTUC income car insurance claims against me for an accident that happened in July 2008.
The car infront suddenly braked and I had no time to response and knocked into the rear of that car, that car rear bumper slightly caved in but the passengers were alright and three of them also came out and walked around.
That car was moving off from a slip road to a main road.
The authorized reporting center told me that I was in the wrong as I had knocked into the rear of that car.
Now, NTUC Income had approved a injury claim of $12K and three other injuries claims are still pending but there are no car damage claims!
How can a car not be damaged but the persons inside are injured?
I smell some rats here trying some scams.
Should not the authorities clamp down on such activities?
Or should I say crimes, as there are intentions to cheat.
This is the reason for us to fork out more and more for car insurance premiums.
Now, the other party trying another scam by sending someone to send some documents to me, which I had no dealings with as NTUC Income is the one taking over all the claims and proceedings.
As you were once NTUC chief, you know very well how NTUC operates, I would like your comments.
Thank you for posting my comments and let other people shared and be warned of such things that can happen.
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