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Enhancing Consumer Protection and Fraud Prevention in the Financial Sector

This presentation by G.V. Rao assesses the implementation of core principles essential for consumer protection in the financial sector. It discusses the importance of accountability, public consultation, and resources needed for effective oversight. Key topics include the criteria for fair treatment of consumers, efficient claim processing, and measures to prevent insurance fraud. Rao emphasizes the necessity for regulatory bodies like IRDA to enhance their frameworks and for insurers to improve transparency and consumer education regarding rights and obligations.

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Enhancing Consumer Protection and Fraud Prevention in the Financial Sector

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  1. Financial Sector Assessment Program Implementation of Core Principles 25, 27 and 28 29th December 2010 G V Rao -Presentation

  2. What ICP coverage should mean?. • Possession of Authority/Implementation of Principle. Resources/ Capacity- observance. • Public consultation for transparency to make new rules. • Accountability for action needed. • Assessing framework to indentify gaps in consumer protection & market stability. ( To provide industry/consumer perspectives). G V Rao -Presentation

  3. ICP 25—Consumer Protection. 1. “ SA sets minimum requirements - insurers & intermediaries dealing with consumers. 2.“Strengthen consumer confidence in market. 3.Treat consumers fairly—info’-wise. 4.Good claim resolution process for fairness. 5.Access to information/consumer rights/obligations. G V Rao -Presentation

  4. Essential criteria & Evidence. 1. Are insurers/intermediaries dealing with consumers with due skill, care, diligence? 2. Do insurers have policies & systems & provide training to employees on these? 3. Requirements to seek info’ from consumers. Are they outdated? 4. Norms for effective, fair, simple, accessible & equitable claim process, need review? G V Rao -Presentation

  5. One view? • IRDA has legal framework to implement. • IRDA to record procedures & accountability to enable insurers & intermediaries to achieve set requirements. Within? • Consumers to know what these are? • How is that done now by each? • Consumer ignorance of protection-huge? • IRDA- oversee insurers implement goals. G V Rao -Presentation

  6. Claim processing—change proposed? • Claim two aspects—liability & quantum. • Both are decided in one go & a long time. • Determine liability first; arbitration helps. • Empower customer to negotiate claim? • No surveyors fined for breach of COC? • Insurers now dictate on assessment prior to accept liability of claim. • Modify current claim policy condition. G V Rao -Presentation

  7. Suggestion on Licensed Surveyors. • Like in TPA, Agency, have written contracts between insurers & surveyors. • Surveyors should be sued for delays, wrong & faulty discharge of functions & duties. • Surveyors like brokers must have PI for at least Rs 1 crore. So should TPAs—all outsourced outfits. G V Rao -Presentation

  8. ICP 27- Frauds. • SA requires insurers & intermediaries take measures to prevent, detect and remedy insurance fraud. To communicate with other SA to detect. If there are specific legal provisions-fraud? All in insurance chain are likely perpetrators. Fraud results reputational, financial damage and adds to social & economic costs. G V Rao -Presentation

  9. Essential Criteria. • SA has powers & resources combat fraud? • Does legislation cover—definition fraud? • High business integrity standards. • SA requires insurers etc. devote resources. • Counter-fraud training to staff. • Co-operates with other SAs. G V Rao -Presentation

  10. Comments on Fraud. • Fraud—is it defined in Indian law? • Vigilance covers only PSU internal staff. • Private sector to have CVOs? GI Council? • Surveyors & Brokers to have CVOs, as they are organized as Associations. • Insurers to have counter-fraud training? • Deliberate breaches of current safety legislation—is it fraud on insurers? G V Rao -Presentation

  11. AML, combating Terrorism-28. • SA requires, at least life insurers and others offering investment products and intermediaries to detect, prevent& report ML & financing of terrorism—Financial Action Task Force. G V Rao -Presentation

  12. Essential Criteria. • FATF recommendations. • AML/CFT requirements. • AML regulations. • Sensitization of regulatory framework. • Maintenance of data for 5 years. • Insurers to develop procedures, systems & training to detect AML/CFT. G V Rao -Presentation

  13. To be listed by each insurer and other entities—and how these are supervised, audited, and action taken for implementation. Systems, processes & accountability? G V Rao -Presentation

  14. Last slide. • Consumer protection needs fresh look. • Insurer procedures must be self-contained. • Insurers to play bigger role than now. • GI council has to take on accountability. • Surveyors and claim process need relook. • Private players to have Vigilance outfits. • IRDA to develop inspection expertise for ICP implementation—work with others. G V Rao -Presentation

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