BUSINESS &

CLAIM PROCESSING IN
UIIC BRANCH OFFICE

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 TITLE OF CONTENT
SECTION TITLE PAGE NO
1 ABOUT INSURANCE 3
AND IT’S HISTORICAL
BACKGROUND
2 COMPANY PROFILE 7
3 PROCESSING WORK 14
IN THE UIIC IN
DHARMAPURI
BRANCH OFFICE
4 CASE STUDY IN 22
GENERAL
INSURANCE
5 ACTIVITY DIARY 25

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 CHAPTER 1
ABOUT INSURANCE

Insurance is a form of contract between two parties (namely insurer and

insured or assured) whereby one party (insurer) undertakes in exchange for a
fixed amount of money (premium) to pay the other party (insured).
Insurance covers the risk, but it does not prevent the risk. Insurance is
really an element of business, without it, no vehicle of transport, in sea or land
or in the air is allowed to move, nothing built and no wheel turns. Every wise
businessman secures himself to insurance.
Insurance is the form of risk management primarily used to hedge
against the risk of contingent, uncertain loss.

TYPES OF INSURANCE

INSURANCE

LIFE GENERAL

FIRE

MARINE

MISCELLANEOUS

HEALTH

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LIFE INSURANCE

Life insurance is a financial contract between an individual (the

policyholder) and an insurance company. In short, life insurance provides a
death benefit to the beneficiaries named in the policy upon the death of the
insured person. The policyholder pays regular premiums to the insurance
company to maintain coverage. Life insurance serves as a financial safety net,
offering protection and financial support to the policyholder’s loved ones in
the event of their death. Additionally, some life insurance policies may
accumulate cash value over time, which can be assessed or borrowed against
during the
policyholder’s lifetime.

GENERAL INSURANCE

General insurance is a type of insurance coverage that provides

financial protection against a wide range of risks and perils, excluding life
insurance. It is also known as non-life insurance. General insurance policies
protect individuals, businesses, and other entities from the financial
consequences of unforeseen events and liabilities. General insurance plays a
crucial role in helping individuals and businesses manage risks and recover
financially from unexpected events. The specific coverage and terms of general
insurance policies vary, and individuals can choose policies based on their
unique needs and circumstances.

General insurance classifies into three types: Fire, Marine,

Miscellaneous.

HEALTH INSURANCE

Health insurance is a type of insurance coverage that provides

financial protection to individuals or groups against the cost of medical
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expenses arising from illness, injury or other covered health-related events.
It serves as a crucial tool in managing the high costs associated with
healthcare and medical treatments.

Health insurance is essential for managing healthcare costs,

providing individuals and families with access to necessary medical services,
and protecting against financial hardships associated with unexpected health
issues. It is often obtained through employers, government programs (such as
Medicare or Medicaid) or individual policies purchased on the private market
or through health insurance exchanges.

HISTORICAL BACKGROUND OF INSURANCE

Some of the important milestones in the insurance business in India

are:

1818: British introduced the life insurance to India with the establishment of
Oriental Insurance company.

1850: Non-life insurance company debut with triton insurance company.

1870: Bombay mutual insurance society is the first India owned life insurer.

1907: The Indian Mercentile Insurance Ltd. Set up, the first company to
transact all classes of general insurance business.

1912: The Indian Assurance Companies Act enacted as the first statute to
regulate the life insurance business.

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1928: The Indian Insurance Companies Act enacted to enable the government
to collect statistical information about both life and non-life insurance
business.

1938: Earlier legislation consolidated and amended to by the Insurance Act

with the objectives of protecting the insuring public.

1956: 245 Indian and foreign insurers and provident societies taken over by
the central government and nationalized. LIC formed by an Act of Parliament
(LIC
Act,1956) with capital contribution of Rs. 5crore from the Government of India.

1957: General Insurance Council, a wing of the Insurance Association of India,

frames a code of conduct for ensuring fair conduct and sound business
practices.

1968: The Insurance Act amended to regulate investments and set minimum
solvency margins and the Tariff Advisory Committee set up.

1972: The General Insurance Business (Nationalization) Act, 1972 nationalized

the general insurance business in India with effect from 1 st January 1973

1993: Malhotra committee was constituted under the chairmanship of former

RBI chief R.N. Malhotra to draw a blue print for insurance sector reforms

1994: Malhotra committee recommended re-entry of private player

1997: IRDA (Insurance Regulatory and Development Authority) was set up as a

regulatory of the insurance market in India, 2000. IRDA started giving license to
Private insurers.

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2001: The first non-life insurance sector was started to sell an insurance

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 CHAPTER 2

ABOUT UNITED INDIA INSURANCE COMPANY

United India Insurance company Limited was incorporated as a

company on 18th February 1938. General Insurance Business in India was
nationalized in 1972. 12 Indian Insurance Companies, 4 cooperative Insurance
societies and Indian Operations of 5 Foreign Insurers, besides General
Insurance operations of southern regions of Life Insurance corporation of India
were merged with United India Insurance company Limited. After
Nationalization United India has grown by leaps and bounds and has over 9000
work force spread across 1537 offices providing insurance cover to 1.74 Crore
policy holders. The company has variety of Insurance Products to provide
insurance cover from bullock carts to satellites. United India Insurance
Company has also made their presence in more than 1000 tier Ⅱ and Ⅲ towns
and villages through our innovative Micro Offices.

UIIC VISION

 To become the most preferred insurer in India, with global footprints

and recognition.
 To become the best-in-class customer service provider
leveraging technology and multiple channels.
 To become the provider of a brand range of innovative products to
meet the needs of all customers segments.
 To be a great place to work, with highly motivated and
empowered employees.
 To be recognized for its contribution to the society.

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 UIIC STANDARDS FOR SERVICING

 Strive to carry out the timeliness as prescribed by the Regulator

in respect of policy holder’s servicing.
 Be clear and transparent in seeking fulfilment of requirement
for settling a claim or any other services to the customers.

PRODUCT OFFERING IN UNITED INDIA INSURANCE COMPANY-

BRANCH OFFICE

NON-
MOTOR
MOTOR

LIABILITY
FIRE
ONLY

PACKAGE POLICY BULGARY

CATTLE

HEALTH

Many products available in UIIC. But some of the products are servicing to fulfil
people need. Here, most of the areas are rural. Here are some details about
the products.

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LIABILITY ONLY POLICY

Liability only policy is nothing but Third party Motor insurance. It is

compulsory Insurance in India. An insurance policy in which the third party and
his/her property or vehicle is covered but the insurer or his vehicle is not
covered. Personal accident cover for the owner driver for a specified sum
insured.

LIMITATIONS AS TO USE:

The policy covers use only under a permit within the meaning of
Motor vehicles Act, 1988 or such a carriage falling under subsection 3 of
section 66 of the Motor Vehicles Act, 1988.
The policy does not cover use for:
 Hire or Reward
 Carriage of goods (other than samples or personal luggage)
 Organised Racing
 Pace Making
 Speed Testing and Reliability Trails
 Use in connection with Motor Trade

EXCLUSIONS:

 Any accidental loss or damage or liability/ caused or sustained

or incurred outside the geographical area.
 Any claim arising out of any contractual liability
 Any accidental loss or damage to any property whatsoever or
any loss or any expense whatsoever resulting or arising there
from or any consequential loss.
 Any accident loss, damage or liability directly or indirectly
caused by or conducted to, by or arising from nuclear weapons
material.
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 PACKAGE POLICY

SECTIONⅠ:(OWN DAMAGE-OD) OF PACKAGE POLICY:

It covers loss or damage to the vehicle and/or accessories.

SECTION Ⅱ: LIABILITY TO THIRD PARTIES:

 The company will indemnify the insured in the event of an
accident caused by or arising out of the use of the insured vehicle
against all sums which the insured shall become legally liable to
pay.
 The company may at its own options (a) arrange for
representation at any inquest or fatal inquiry in respect of any
death which may be the subject of indemnity under this policy
and (b) undertake the defence of proceedings in any courts of
law in respect of any act or alleged offence causing or relating to
any events which may be the subject of indemnity under the
policy.

SECTION Ⅲ : PERSONAL ACCIDENT COVER FOR OWNER-DRIVER:

The company undertakes to pay compensation as per the scale for
bodily injury/ death sustained by the owner-driver of the vehicle, in direct
connection with the vehicle insured or whilst driving or mounting into
dismounting from the vehicle insured or whilst traveling in it as a co-driver,
caused by violent accidental external and visible means which independent of
any other cause shall within six calendar months of such injury.

FIRE POLICY

It covers the cost of damages and losses caused by a fire. It allows the
policyholder to declare the risk and value of each insured entity separately,

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offering better coverage and protection. If any Insured property is
physically

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damaged, lost or destroyed, company will pay the Insured. In any claim ,
Company will not pay more than the relevant sum insured, subject to
underinsurance.
Accidental physical damage is made as default cover i.e. due to any
external peril.

BURGLARY FIRST LOSS POLICY

a) Any loss of or damage to property or any part thereof whilst

contained in the premises described in the schedule hereto due
to
burglary or House-breaking ( theft following upon an actual
forcible and violent entry of and/ or exit from the premises) and
hold-up
b) Damage caused to the premises to be made good by the
Insured resulting from burglary and/ or house-breaking or any
attempt there at any time during the period of insurance.

EXCLUSION:

 Loss or damage which is recoverable under fire or plate

glass insurance policy, or any other policy.
 Consequential loss or legal liability of any kind.
 Loss of money and/or other property abstracted from safe
following the use of the key to the said safe or any duplicate key
thereof belonging to the insured, unless such key has been
obtained by assault or violence or any threat thereat.
 This policy shall cease to attach if the premises shall have been
left uninhabited by day and night for seven or more
consecutive days and nights while the premises are left
uninhabited.
 If the insured shall cause or suffer any material alteration to be
made in the premises or anything to be done whereby the risk
is increased.
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 MICRO-INSURANCE PRODUCT-CATTLE INSURANCE POLICY

If any animal described in the schedule and belonging to the insured

shall die from any disease or accident( including fire and lightning)
contracted or occurring during the period of insurance stated herein or any
subsequent
period in respect of which the insured shall have to paid and the company shall
have accepted the premium required for the renewal or extension thereof the
company will pay to the insured after receipt of proof of death satisfactory to
the company the loss which the insured shall suffer by the death of such
animal not exceeding the sum insured in respect thereof as stated in the
schedule
hereto or its market value at the time of loss whichever is less. However, the
company’s liability is restricted to 50% of sum insured or market value
whichever is less if the annual prior to death giving rise to a valid claim under the
policy is not pregnant or four months less of pregnancy or not in milk
production.

EXCLUSIONS:

 Malicious or wilful injury or neglect, over loading unskillful

treatment or use of animal for purpose other than stated in the
policy without the consent of the company in writing.
 Diseases contracted prior to commencement of risk. And
provided always that-any claim arising out of the disease or
illness
contracted by the animal during the first 15 days from the
commencement date of the policy. This exclusion shall not
however, apply if insurance is in existence for a continuous period of
12 months without any break.
 Theft or clandestine sale of the Insured animal.
 Intentional slaughter of the animal except in cases where
destruction in necessary to terminate incurable suffering on
humane considered on the basis of certificate issued by qualified
veterinary surgeon or in cases where destruction is resorted to
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by order of lawfully constituted authority.

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FRAMEWORK OF GENERAL INSURANCE COMPANY

PRODUCT/SERVICE DEVELOPMENT
MARKETING AND SALES POLICY ADMINISTRATION CLAIMS MANAGEMENT ASSET MANAGEMENT

UNDERWRITING PROMOTION TRANSACTION CLAIMS PORTFOLIO

NEW PRODUCTS CROSS SELLING PROCESSING SUBMISSION MANAGEMENT
MANAGING PRODUCT OFFERINGS
UPSELLING PAYMENTS CLAIMS RISK ANALYSIS
PRICING TARGET MARKETS SETTLEMENT ASSET-LIABILITY
RESEARCH PAYMENTS MANAGEMENT
RISK PREVENTION AND MITIGATION FRAUD

WHAT ARE THE PROCESS ONGOING IN UNITED INDIA INSURANCE

BUSINESS OFFICE (BRANCH OFFICE)

1. Marketing
2. Underwriting of risk
3. Premium collection
4. Customer servicing
5. Claim intimation
6. Forwarding to claim servicing hub

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 CHAPTER 3

MARKETING

Marketing is done by Agent and Insurance advisor.

Their work is invaluable to Insurance company. Agent acts as a
bridge
between an organization that product or service and the potential
buyer. The quality of performance of such a professional
primarily depends on three aspects of the product: knowledge,
skill and
attitude.
Selling is defined as creating a human need and fulfilling it. A
prospect may not felt the need for insurance at all. It is therefore
necessary that a sales executive should communicate in such a way so
that the need is felt by the prospect. This requires the ability to
communicate on the part of the sales personnel.

AGENT COMMISSION:

The commission is the incentive that the insurance agents or

the sales representative receive after selling the insurance policy, be
it non-life. The commission is paid as a percentage of the premium
under the insurance policies.

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 NEW VEHICLE OWN RENEWAL ROLLOVER SATP INCENTIVE
OD TP OD TP OD TP OD OD+TP
TWO WHEELER
UPTO 350 CC NON ELECTRIC 20 20 20 20 20 20 20 10
ABOVE 350 CC 15 15 15 15 15 15 15 10(RE ONLY)
ALL BRAND ELECTRIC 20 20 20 20 20 20 20 10

PRIVATE CAR
UPTO 1500 CC PETROL 17.5 17.5 15 15 15 15 15 5
ABOVE 1500 UPTO 2500 CC PET OR DIS 17.5 17.5 15 15 15 15 15 5
UPTO 1500 CC DIESEL 10 10 5 5 5 5 5 NULL
NEW CAR 10

COMMERCIAL PCV
AUTO 20 20 20 20 20 20 25 10
UPTO 1000 CC 6 PASSENGER 10 7.5 10 7.5 10 7.5 15 5
UPTO 1500 CC 6 PASSENGER 10 10 10 10 10 10 10 5
6 TO 20 PASSENGER 15 10 15 10 10 10 10 3
20 TO 30 PASSENGER 10 10 10 10 10 10 10 3
ABOVE 30 PASSENGER 4 4 4 4 4 4 4 3

COMMERCIAL GCV
UPTO 2000 GVW 25 25 25 25 25 25 25 10
2001 TO 10000 GVW 15 20 15 20 15 20 20 5
10001 TO 12000 GVW 4 5 4 5 4 5 5 4
120001 TO 20000 GVW 5 5 5 5 5 5 5 4
20001 TO 32000 GVW 7 7 7 7 7 7 7 4
32001 TO 40000 GVW 5 5 5 5 5 5 5 4
40001 ABOVE 4 4 4 4 4 4 4 NIL

MISC TYPE VEHICLE 15 8 15 8 15 8 8 5

SACPA NA 15 NA 15 NA 15 15

Cattle Insurance: 15% Agent Commission

Bharat GrihaRaksha policy: 25% Agent Commission
United Bharat sookshma(below 5 crores) and Laghu udyam Suraksha
policy(above 5 crores): 20% Agent commission
United value GrihaRaksha policy: Exclusion- Terrorism- 20% Agent Commission
Burglary First loss policy: 15%

These are basic details of agent commission in united India Insurance

company.

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PROPOSAL FORM

Proposal form is the most important and basic document required

for non-life insurance between the insured and insurer. It is basic to get the
knowledge about the risk evolved in the proposal form. With the help of
proposal form, it is easy to accept or reject the risk. In Non-life insurance there
are so many different details are required based on their vehicle, property,
health etc. to obtain from insured. Here are some of the basic details required
to comply the proposal form are:

FOR MOTOR INSURANCE:

 RC
 Driving License
 Aadhar card
 PAN Card

FOR NON-MOTOR INSURANCE:

 Health: Aadhar card, PAN card
 Compulsory Personal Accident: Aadhar card, PAN
card, Driving License.
 Cattle: photocopy of cattle, Doctor report with
his/her signature, Aadhar Card, Ear tag of cattle.

UNDERWRITING OF RISK

Underwriting has to do with the selection of subjects for

insurance in such a manner that general company objectives are met. The
main objective of underwriting is to see that the risk accepted by the insurer
corresponds to that assumed in the rating structure

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 The premiums for each individual or business in the pool are
calculated by weighting relevant risk factors depending on their likelihood. For
liability only need IDV (Insured Declared Value).

For calculating the premium, approach the UIIC portal and

then fill the details step by step at the end will get the premium for the
vehicle.

Premium charge as per IRDA Website:

On Premium Rates for Motor Third Party, Liability

insurance cover for the financial year.

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CUSTOMER SERVICING

Once agent have collected proposal with premium, he visit

insured if it possible to give the policy or after ward meet the insured and
explain the details under the policy. Click on correctness of data and ask
insured to call him for any requirement.
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All the good-well created by the above contacts will be lost if the agent don’t
intimate a customer well in advance about the renewal date of the policy.
Follow up with a reminder and then actually collect or help the insured renew
the policy prior to expiry so that your customer gets continuous protection.

CLAIM INTIMATION AND FORWARDING TO CLAIM HUB

SERVICE:

Claim Intimation - the insured intimates the insurer with the loss expected
amount and submits all the mandatory claim documents, no later than 60 days
from the date for the loss.

Claim Assessment - The Claims Team scrutinises the documents and also the
appointed surveyor will investigate and assess the claims and if there are any
pending requirements, the same are communicated to the claim beneficiary
through a requirement letter.

Claim Decision - The claim is approved and then settled. Subsequently, a

payment is made to the beneficiary’s bank account by NEFT. If the team
rejects the claim, a communication providing the reasons for rejection is sent
to the beneficiary.

CLAIM PROCEDURE:
 Inform the insures immediately, quoting policy no.
to enable them to arrange for a survey.
 Inform the police about the accident, if third
part injury/property damage is/are also
involved.
 Note the names and addresses of witnesses present
at the time of accident.
 Submit an estimate of repairs to your insuring office
or the nearest office of the insuring company.
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  Do not undertake the repairs till the insurers approve
the estimate of the cost of repairs/replacements.
 Give any additional information, if available. That
helps the insurers settle the claim faster.
 Please keep ready and present the following
documents to the surveyor for verification when asked
for:
(a) Driving License (b) R.C. Book
 In case of Commercial Vehicles, please keep ready
(a) Route Permit (b)Fitness Certificate (c) Badge (Taxi) also.
 After the repairs are over, you will have to sign
a satisfaction certificate and submit to the
repairs.

SURVEYOR PREPARES THE REPORT AND ASSESSMENT AND SUBMIT IT

TO UNITED INDIA INSURANCE COMPANY FOR FURTHER PROCESSING:

 This is the most important part of the claim

settlement because it is all up to the surveyor that
how much the payable amount should be given to the
insurer.
 He prepares a brief report on his/her survey and
prepares FSR (Final survey Report).
 While preparing the report he should state whether it
is payable claim or not
 Then he must check whether the occupancy of the
business owner is as same as he stated in the policy or
differs “occupancy” means the activity carried out in the
insured premises stated in the schedule and for the
purpose for which the same is used.
 “period of Insurance” means the period during which
cover is provided by this policy of Insurance as specified in
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policy copy. The loss should take place after 15 days of
the policy period and should take place before 15 days of
the

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 end of the period of policy otherwise it will be no claim
under Close proximity cause.
 Now surveyor is ready to do the assessment.
 Based on the report claim team process the claim for
payment/repudiation/post loss endorsement and surveyor
will pay his fees.

What is IDV?
IDV refers to Insured Declared Value and is the
maximum sum assured fixed by the insured that is offered in
case of theft or
total loss of a vehicle. In short, IDV is the current market value of the
vehicle. The IDV is the primary factor behind the policy premium
and the claim settlement limit of the vehicle.
Maximum compensation against the insured vehicle
depends on its IDV. At the time of claim settlement, the repair and
replacement expenses of the vehicle parts are based on its IDV.
While declaring an unnecessarily high IDV can result in a
high policy premium, declaring a low IDV can result in a low sum
insured.

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 CHAPTER 4

LEARNING OUTCOME:
CASE STUDY ON GENERAL INSURANCE
Case 1-Between LMV MOTOR CAR (Insured) and LORRY: Third party
motorcyclist involved.
Cause of accident: The information gathered that the insured vehicle while
plying near the accident spot a third party motorcyclist proceeding in the front
turned suddenly towards right side hence the insured vehicle went out of
control dashed against that motorcycle and sustained the damage. (It’s from
the investigator report)
What I learnt from the report and FIR: A Negligent lorry driver hit LMV motor
car and a person died by this accident. It happened in Dharmapuri to
Tiruvannamalai road, that lorry driver report says that the car driver did not
flashed the right indicator. Due to not flashing the indicator, accident
happened.

Case 2- REPUDIATION CASE IN MOTOR: Third party involved. The insured

motor cycle proceeding at said accident spot and insured motor cycle rider
tried to cross the road from west to east direction and suddenly a third party
motor cyclist bearing registration number came rashly from opposite direction
and hit against to insured motor cycle. Hence, insured motor cycle sustained
damage and been hospitalised.
Cause of repudiation: Insured’s driver doesn’t have MCWG endowment
License to drive the insured Two-wheeler vehicle at the time of accident.

Case 3-CATTLE CLAIM: Insured and UIIC (Insurer)

Cause of Death of the cattle: Rumen impaction.

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Status of tag: Tag was intact on the ear of the cow. Doctor has confirmed death
of the animal with tag number. Post mortem done next day.
Attachment for claim: Livestock claim, postmortem certificate, cattle death
claim intimation, Request letter, villagers witness letter with signature, Bank
statement, Description of animal cattle, PAN card, Aadhar card, Ration Card
and photos of the death cattle.
Cause of denial of the claim: It appears that the insured cow clandestinely
been sold to brother of the insured. And insured told that the cow milk
supplied to milk centre till the death. But it is not true. The milk centre
informed
Dhanasekaran stopped supplying milk to the centre about 14 days. Claim
arising out of the death of the animal is not tenable
As per the policy cover, clandestine is in [Link], the insurer
doesn’t accept the claim.

Case 3- PACKAGE POLICY CLAIM: Hyundai car (Insured vehicle)

Cause of Accident: Insured’s driver was proceeding the vehicle from
Dharmapuri to Salem national highway. Unfortunately, driver lost his control
and hitting on the ongoing sugarcane load vehicle Tractor rear side, it caused
damaged the insured’s vehicle on the front side. In this accident all the 3
passengers including driver were injured. The insured vehicle is considered
total loss.
Document required: claim intimation form, repair estimation, FIR, DL of Driver,
RC, Motor final survey report, photo copies, Registration certificate cancellation
letter.
Insured agreed to sell the salvage/wreck of the insured vehicle for some
price at his own risk and surrender the RC to concern RTO and submit RC
surrender certificate to insurer.

Case 4- OWN DAMAGE CLAIM: Nissan Motor car (Insured)

Case of Accident: As stated in the claim form, while insured car at said
crossing signal point and a Two wheeler bearing registration number tried to
crossing

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signal point without getting green signal and in the unexpected cause.
Insured car driver unable to control insured car and as resultant to that
insured car hit

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against to Third party two wheeler. Hence, insured car sustained damage and
the person is spot death.
Document required: claim form, FIR, policy cover, driving License, Aadhar card,
PAN card, Bank passbook, Driving license, bills and photo copies.

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