IRDA File and Use

For selling any general insurance product in the Indian Market it is essential to comply with the requirements of File and Use (F&U) guidelines prescribed by IRDA. Insurer is not permitted to offer any product for sale until all queries pertaining to the produce have been satisfactorily resolved after filing and IRDA confirming in writing that it has no further queries in respect of that product. IRDA has the right to question terms and/or issue directions, suspend a product or withdraw from the market if, at any time, it appears to IRDA that it is not appropriate for any reason or does not carry rates, terms and conditions that are fair between the parties or the documents used with the product are in any way unsatisfactory notwithstanding the fact that IRDA may have had no subsisting queries in respect of that product when it was originally filed. The insurer needs to justify the rates, terms and conditions of insurance offered to a particular client or to a class of clients for a particular product while filing the product with IRDA.

IRDAI’s Initiative on frauds in insurance for Frauds in Insurance

Anti-Fraud Policy : All insurance companies are required to have in place an Anti-Fraud policy duly approved by their respective Boards. The policy shall duly recognize the principle of proportionality and reflect the nature, scale and complexity of the business of specific insurer and risks to which they are exposed. While framing the policy, the insurance company should due consideration to all relevant factors including organizational structure, insurance products offered, technology used, market conditions, etc. As fraud can be perpetrated through collusion involving more than one party insurers should adopt a holistic approach to adequately identify, measure, control and monitor fraud risk and accordingly lay down appropriate risk management policies and procedures across the organization. Important aspect of Anti-fraud policy to include procedure for fraud monitoring, identification potential areas of internal fraud, policyholder fraud, claims fraud, intermediary fraud, coordination with law enforcement agencies, framework for exchange of information, due diligence, regular communication channels and fraud monitoring and preventive mechanism.