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CMA Final · Risk Management in Banking and Insurance · Concept and Types of Health Insurance Policies

A health insurer's record-keeping under Section 14 of the Insurance Act, 1938 (as reproduced) is being reviewed. Which statement is correct?

The record of claims must show every claim with its date, the claimant's name and address and the discharge date, or for a rejected claim the date of rejection and the grounds. It is not limited to paid claims, and electronic form is permitted.

  1. AThe record of claims must show the date of claim, the claimant's name and address, and for a rejected claim the date of rejection and its groundsCorrect
  2. BThe record of claims need only show claims that were paid, with the date of payment
  3. CRecords of policies and claims may be kept only in physical registers
  4. DPolicy records need not show any transfer, assignment or nomination

Explanation

Section 14(1)(b) requires each claim to be recorded with its date, claimant's name and address, discharge date, or for a rejected claim the rejection date and grounds. Records may be electronic under 14(1)(c), and policy records include notified transfers, assignments and nominations, so the others are wrong.

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