
The Office of the Insurance Commission (OIC) has issued measures to speed up the claims process for Covid-19 insurance after payment delays were reported.
The OIC met on Aug 31 to discuss implementing measures and taking legal action against insurers that intentionally delayed payments for Covid-19 insurance during the pandemic.
The measures, effective from Sept 1, were issued to supervise insurance companies' claims processes and enforce consumer protection laws, including an in-depth examination of companies' handling of complaints, both those filed with the OIC and directly to insurance companies, in order to expedite the claims payment process.
In addition, the OIC issued an order to set up four working groups to help screen and reassess the conditions of insurance policies in case of disputes. The groups can also help defuse any arguments between companies and policyholders that may delay the payment of claims.
The OIC will strictly enforce the laws to protect consumer rights, said secretary-general Suthiphon Thaveechaiyagarn.
After issuing the measures, he said the next step is a discussion with representatives from various agencies, such as the Public Health Ministry, the Medical Council, the Private Hospital Association, the Office of the Consumer Protection Board, Thai Life Assurance Association and the Thai General Insurance Association.
The meeting is scheduled for Sept 12 to collect opinions from relevant agencies and develop guidelines to ensure compliance from insurance companies.
The OIC insisted insurers under its supervision remain in good financial health with ample reserves that exceed what the law requires, despite losses from surging Covid-19 insurance claims.
According to Mr Suthiphon, the OIC received 1,671 complaints about Covid-19 insurance from policyholders nationwide this year, an increase from 1,305 complaints in 2020. Most of the complaints were about delayed lump-sum payments.
He said insurance companies have told the OIC they are not intentionally delaying payments.
According to data from insurers, the delay was due to surges in claims, when some companies reportedly had more than 1,000 policyholders filing a Covid-19 claim each day.
To accelerate the process, the OIC asked insurance companies with 100 or more complaints per day to set up an agency to specifically process Covid-19 claims, finish checking the evidence within three days, and pay compensation within 15 days after checks are complete.
The companies are also required to notify customers if evidence is incomplete and pay compensation within 15 days after they have received all relevant documents.
If there is a problem in the interpretation of conditions, the company must submit the case to the OIC within seven days and report progress every 15 days.
"These orders will help insurance companies optimise the claim settlement process and provide a record for the OIC to quickly tackle problems," said Mr Suthiphon.
In the past week, there have been complaints against One Insurance Plc, formerly known as Assets Insurance, and Southeast Insurance Company after the companies failed to pay compensation to Covid-19 insurance claimants as scheduled.
Southeast Insurance said it was in the process of adjusting the claim notification system and insisted all claims would be paid.
Viriyah Insurance said it received more than 1,000 insurance claims per day, causing the system to slow. Viriyah said it resolved the problem by increasing staff numbers and allowing customers to file claims at any branch.