8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 1/9

 Arun Patil

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 2/9

Ombudsmany Set up in 1998 by GOI to handle complaints of 

aggrieved insured persons & their quick disposal

y Appointed by Insurance Council on recommendationsof a Committee of Chairmen of LIC, GIC & GOI rep.

y From insurance industr y/civil services/judiciar y 

y 12 Offices at Bhopal, Bhuvaneshwar, Cochin,

Guwahati, Chandigarh, Delhi, Chennai, Kolkata, Ahmedabad, Lucknow, H y derabad & Mumbai

y Pow ers: 1. Conciliation 2. Award making

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 3/9

Ombudsman (contd.)y Complaints relating to claims, premiums, legal points,

non-issue of polic y etc.

y Up to Rs. 20 lakhy Complaints in writing within 1  y ear

y Award within 3 months

y Binding on insurance companies

y Stead y increase in complaints & disposal shows thatpolic y holders have reposed faith & trust in this s y stem

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 4/9

Lok Adalat (Peoples Court)y Alternate Dispute Resolution to reduce court burden

y Equal access to justice a constitutional right for all

Indian citizens under Art. 39A y Rooted in historical & cultural Panchayat system

y  Act passed in 1987

y Presided over by  retd. Juducial official + 2 members

yConciliation & compromise of pending court cases

y Both parties must agree for settlement no fee

y Decision binding on parties no appeal

y Mone y claims, partition, matrimonial, Third part y (MACT)

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 5/9

Right to Information Act, 2005y Mandates timel y response to citizens requests forGov t. inf ormation

y To promote transparency & accountability in the working of public authorities (corruption?)

y Inf o.= work, documents, records, notes, minutes,tapes, CDs, certified copies

y All public authorities to maintain records of emplo y eessalaries, decisions, powers, minutes, budgets

y Written requests to P.I.O. with fee who will compl y   within 30 da y s

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 6/9

RTI (contd.)y Reasons f or rejection to prov ide inf o. (securit y ,

strategic interests of State, trade secrets, legal bans,

endanger life/propert y , privac y , no public interest)y C.I.C. & State Information Commissioner

y E v aluationof RTI

y Partial success onl y  13% rural & 33% urbans knowabout RTI !!

y Over 75% info-seekers dissatisfied

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 7/9

FERA 1973now FEMA 1999y FERA violation a criminal offence.FEMA violation a

ci v il offence

y FERA was drasticguilt y unless proven innocenty Liberalized econom y & WTO forces

y RBI to make rules &  w ithout its permission nodealing in foreign exchange make or receive pa y ment

outside Indiay Penalty : 3 times sum involved/2 lakh/Rs. 5000 per da y 

y Several controversial cases

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 8/9

Legal aspects in investigations

y Law of land is supreme

y Companies investigations records, statements, witnesses

y Claims Life & non-life

y Fraud

y Accident, home, car, health, propert y , travel

y Some interesting cases

8/8/2019 Ins Laws & Regs-3

http://slidepdf.com/reader/full/ins-laws-regs-3 9/9

All the best, legal eagles !

yIgnorance of law is noexcuse either in India orin MET exam