PNB MetLife Claim Settlement Ratio

Life insurance has become an integral part of everyone’s life. While purchasing any life insurance plans, considering the claim settlement ratio (CSR) is always an important factor. In 2014, PNB launched the CSR initiative in partnership with JKB and KBL.

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PNB MetLife Insurance believes that the rightful claims should be settled efficiently through continuous customer service. 

What is the Claim Settlement Ratio?

An insurance claim refers to the request made by a policyholder to the insurance company for the payment of a loss based on the insurance policy terms. It is a formal request which is validated by the insurance company. Once approved the insurance company provides monetary support to the insured. Claim Settlement Ratio (CSR) refers to the coverage made by the insurance company against the number of claims filed. It is considered to be one of the important factors while deciding on the insurance company for purchasing an insurance plan. A higher claim settlement ratio refers to a better insurance provider. Therefore, before selecting an insurer it is advisable to check the CSR of the insurance company.

PNB MetLife Claim Settlement Ratio

PNB MetLife Claim Settlement Ratio denotes the percentage of claims the insurance company gained in a financial year. IRDAI releases the claim settlement ratio for life insurance every year for all insurance providers. The following formula is used to calculate the claim settlement ratio:

Claim Settlement Ratio = (Number of settled claims /Number of received claims) x 100

If an insurance provider mentions a 95% claim settlement percentage, then it suggests that the insurance company settled 95 claims out of every 100 claims it received. The 5% of the remaining claims were either not settled or might be fake claims.

For ease of understanding the claim settlement ratios are always represented in percentage. The CSR numbers facilitate the selection of the insurance provider. The ratio ensures trust over the company, which finally determines its position in the market.

What does PNB MetLife CSR Represent?

A claim settlement ratio of higher than 80% is reported to be a good factor and further higher than 90% than the insurance product is denoted to be of good value. It is not always the claim settlement ratio that matters; however, the time required to resolve a claim also matters. It directly points towards the efficiency of the insurer. It can be stated as a lower number of days mean higher efficiency and therefore, a high confidence level in purchasing a policy from the company. A time period of thirty days means the efficiency of the company is good. However, twenty days denotes excellent efficiency.

 Similarly, a lower average time denotes that the company might not be fully focused on getting sales. However, the company might be focused on ensuring genuine services during a death claim. 

What Information do we get with the PNB MetLife CSR?

The insurance can be claimed only by the beneficiary, nominated by the policyholder. This means that even a legal heir is not eligible to claim the insurance unless he/she is the beneficiary of the insurance holder. The claim history of the insurer can be retrieved from the official website of the Insurance Regulatory and Development Authority (IRDAI). The information might be used as an important parameter while purchasing an insurance policy.

The PNB MetLife Claim Settlement Ratio for the five financial years from 2014-2019 has been tabulated below:

Financial Year

Claim Settlement Ratio

2014-2015

92.86%

2015-2016

85.36%

2016-2017

87.14%

2017-2018

91.12%

2018-2019

96.21%

Analysis of the CSR for the mentioned five years has shown that the insurance company has maintained the 85% settlement ratio throughout the financial years. For the financial year 2018-2019, a 96.2% settlement ratio is observed. The report states that a total of 4170 claims were received by PNB MetLife Insurance, of which 4012 claims were settled by the company. 

As per the IRDAI annual report, PNB MetLife India Insurance company paid an amount of Rs 204 Crore against the 4012 claims reported. Only 3.76% of claims remained to be resolved which is quite less. This totals 157 claims that were rejected, resulting in 3.76% of Claim Repudiation. PNB MetLife insurance determined that 3.76% of claims did not meet the terms of the policy.

Claims requested are either approved or rejected. Those claims whose decision is still pending are mentioned under the “claims pending” section. The amount for the pending claims is considered as the opening balance for the next year. In addition, all the claims mentioned above include the death claims and not only the claims associated with term insurance.

The company has shown a 97.18% claim settlement ratio for the fiscal year 2019-2020, in the retail business. In addition, the past PNB MetLife Claim Settlement Ratio shows the trend inconsistency of maintaining the settlement ratio. Therefore, the consistent claim settlement ratio of PNB Life insurance is an indication of the company’s honor.  

PNB MetLife Life Insurance Company

PNB MetLife India Insurance Company has been a leading life insurance company in India since 2001. Some of the major shareholders of the company like Punjab National Bank Limited (PNB), MetLife International Holdings LLC (MIHL), Jammu & Kashmir Bank Ltd, M. Pallonji and Company Private Limited, and other private investors, the company provides financial security throughout the circle of life. Four stages of life covered by the PNB MetLife insurance are Child education, Family Protection, and Long Term saving and Retirement.

The Final Verdict

The claim ratio can be taken as a benchmark to display the PNB MetLife insurance credibility. An efficient insurance company will have a high claim settlement ratio. Therefore, if the claim settlement ratio is high, then it indicates its dedicated service towards the policyholder. Claim efficiency plays a key factor while deciding upon a policy, especially the number of days taken to settle the claim. It reflects the importance laid by the company for the processing of claims. The high PNB MetLife claim settlement ratio (over 85%) boosts the trust and assurance of PNB MetLife Insurance Company.

FAQ's

  • Q1. What are the guidelines for claim processing?

    A1. As per the IRDAI guidelines, an insurance company can take up to 30days for settling a claim after receiving the necessary documents. For cases where an investigation is required, a period of 90 days is allowed followed by 30-days for making the final decision.
  • Q2. What is the process to generate a claim?

    A2. A person can intimate PNB MetLife through a financial advisor, branch office claims department at the head office, Regional Service Team, Online, and through channel/partner bank for BABP channel.
  • Q3. Do any exclusion criteria involved in the insurance policies?

    A3. For the first year of the policy, suicide is considered as the exclusion for life cover. Several other rider benefits are considered exclusions as per the terms and conditions of the policy.
  • Q4. If a death occurs abroad, what is the process of claim?

    A4. Similar documents are required for processing a claim of national death. However, the embassy of that country is required to attest to the death certificate.
  • Q5. Who can receive the claim?

    A5. The claim benefits can be received by the nominee if the insurance is for the policyholder. If the insured is for someone other than the policyholder, then the claim will be received by the proposer, assignee, or trustee.
Written By: PolicyBazaar
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