Section 28 in Insurance Regulatory and Development Authority of India (Insurance Brokers) Regulations, 2018
28. Claim Consultancy.
(1)Insurance brokers may undertake claims consultancy only for commercial lines of general insurance business, subject to the following conditions:(a)for claims not exceeding Rs. 10 crore the insurance broker may undertake claims consultancy provided such claim does not emanate from a policy, which has been placed by the same insurance broker.(b)the insurance broker shall inform the Authority within 30 days of acceptance of such claims consultancy by providing details such as name of the client, place of risk, name of the insurer, name of the distribution channel, if any, amount of claim, date of occurrence of loss, mandate obtained from the client for the claims consultancy;(c)for claims exceeding Rs. 10 crores the insurance broker may undertake claims consultancy with the prior approval of the Authority.(d)The application for seeking prior approval under Regulation 28 (1) (c) shall accompany the details such as name of the client, place of risk, name of the insurer, name of the insurance intermediary through whom the policy was originally placed, the reason for not providing the claims assistance to the client by the other intermediary, amount of claim, date of occurrence of loss, mandate obtained from the client for the claims consultancy.(e)before offering the claims consultancy, the insurance broker shall obtain a written mandate from the client to represent the client with the insurer concerned for the claim for which consultancy has been sought by the client and offered by the insurance broker.(f)the insurance broker may charge fee for claims consultancy services as may be mutually decided between the insurance broker and the client. However, such fee shall not be expressed as a percentage of the claim.(g)the insurance broker shall, in all their dealings with such clients, be governed by the provisions of Code of Conduct as specified in Schedule I - Form H and Schedule I - Form I, as applicable, of these regulations.(h)Any dispute between two or more insurance brokers arising out of such claims consultancy arrangements shall, in the first instance, be considered by the Insurance Brokers Association of India (IBAI) and thereafter the IBAI shall forward such dispute together with its recommendation to the Authority for final disposal.(i)The Authority will review and decide the norms regarding claims consultancy from time to time.
