Active Claims Consultants

Corporate

We make the recovery from the Inland carriers, Airlines & Shipping Companies based all over the world under subrogation rights for our client Insurance Companies. We have been recovering crores of rupees from various carriers for our client insurance company every year since 2005.

Generally, there are five types of frauds in Life Insurance segment:

1. Application fraud: This is also called non-disclosure of material fact. At the time of taking policy, the proposer knowingly provides incorrect information to insurance company. Two third of disputed life insurance claims are due to this material misrepresentation.
2. Gangs & Rings: There are gangs and rings in different part of India who are responsible making such kinds of fraud from insurance company. They have been making fake claim with collusion of doctors, medical staff, police and public in general. This is when people attempt to fake their own death or the death of the loved one in order to collect a life insurance benefit.
3. Homicide: This is rear but yes in existence, the beneficiary kills the insured in order to get claim money.
4. Forgery: Generally in this kind of fraud the insured does not involve but other parties accessing the policy and changing the policy owner or beneficiaries.
5. Call center’s fraud: In this kind of fraud, a call center guy calls the victim pretending to be insurance agent and sells fake policy and earn the money in term of premium.

To catch a fraud is always a challenging job but we with the help of our dedicated team we have been exposing fraudsters and playing a vital role in minimizing the loss of our client insurance company since 2005.

1. For General Insurance Segment
2. Marine Investigation
3. Marine Tracing
4. Death Claims under group personal accident, Employee’s compensation
5. Motor OD & Motor Theft
6. Fire & Burglary Investigation
7. Health Insurance Claims Investigation
8. Investigation/verification against insurance agents
9. Any Kinds of Fraud Claim

The effective dealing with the insurance claims plays a pivotal role to keep organization’s financial health in good shape. Insurance is a very technical subject and should be dealt by the person who has a sound knowledge of insurance. In my 20 years of experience I have seen mostly organizations do not have technical person to deal with insurance portfolio. In absence of proficiency, he is not able to deal with insurance claims effectively, even he is not able to choose a good insurance policy for his organisation. Not having of proper documentation and correspondence, there is extra ordinary delay to recover claim money from the insurance company. And sometimes, they even fail to take a valid claim. At last they ended up by blaming insurance companies for not settling of their claims.

There is a general perception in public that insurance company does not want to settle the claims. But in my long career, I did not see even a single case where insurance company had repudiated a valid claim if insured had furnished them all supported documents. Because of inefficiency of their employees, organisations pay a heavy price. Following are most of the reasons which cause repudiation of claim:

1. Misrepresentation or concealment of material fact.
2. Fraud
3. Non coverage of specific peril
4. Excess or Deductible
5. Lack of documentation
6. Where insured is failed to prove his loss on technical ground.