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The Service Level Agreement (SLA) is a timeframe for questions answered or problems resolved related to the company’s business services. It a mutual understanding of customers’ expectation from the services of the company and sets forth a inspection and evaluation standard.
The Office of Insurance Commission requires the insurance companies to determine their key services timeframes such as underwriting, changing of insured’s information, claim payment or policy surrender and notifying the same to insured public and benefit entitled on their corporate’ websites. This also sets Thai insurance industry’s services standard,
SLA plays a significant role in the service systems as specified below, especially the business that relies on trust and speed such as insurance business.
SLA clarifies criteria such as policy approval period or claim payment period. So that customers understand their expectations and transparently monitor and evaluate the services.
Determining the SLAs such as confirming the period of claim assessment process helps to reduce dissatisfaction from delay or others that are likely to occur in the future.
SLA helps the life insurance companies to clearly monitor and assess their performance such as respond time to information change request that enable them for continued improving of the quality of services.
Clarified SLA in business processes such as policy issuance or maturity payment helps them to secure the confidence of the insured and service satisfaction professionally.
SLA helps insurance companies to effectively mitigate their risks from claim payment delay or others that may impact the company’s reputation.
# | Service | PIC |
---|---|---|
1.Standard Service Level Agreement of Individual Insurance | ||
1 | Upon providing life insurance information and policy offerings, agents / brokers must communicate with customers, which are their full name and license no. , source of customers’ contact data, life insurance products that is being offered, premium is not (bank) deposit, premium refund by surrender or cancellation might be in full amount paid, fact stated in application must be correct and true and consequence if stated otherwise, policy deliver period and right to free look. | ตั้Point of sales until policy delivering |
2. Underwriting and after sales services | ||
1 | Underwriting & Issuing | 3-7 days – from required documents received. (*in a case that medical information or exam needed, the company will notify the underwriting result and deliver the policy to insured within 30 days from required documents received, excluding period waiting for health information/exam result and/or other supplement documents requesting from the insured or hospital and counteroffer signed, if any*) |
2 | Policy Deliver | 5 days - from underwriting approved |
3 | Underwriting Data Submission via IBS | 30 days – from the Policy effective date |
4 | Insured’s information Change such as Name, last name or address or contact or phone or premium method | 7 days – from the date of all required documents submitted |
5 | Beneficiary Change | 7 days – from the date of all required documents submitted |
6 | Premium Payor Change | 7 days – from the date of all required documents submitted |
7 | Policy Re-Issuing – Replacement | 15 days – from the date of all required documents submitted |
8 | Policy Paid-up | 7 days – from the date of all required documents submitted |
9 | Extended Term Insurance - ETI | 7 days – from the date of all required documents submitted |
10 | Reinstatement of a policy | 15 days – from the date of all required documents submitted |
11 | Reinstatement due to lapse – overdue premiums with interest paid or effective date postponed with premiums calculated at the rate applicable on the new effective date being paid | 15 days – from the date of all required documents submitted |
3. Policy Benefit Payment | ||
1 | Surrender | 20 days – from the date of all required documents submitted |
2 | Premium Loan | 15 days – from the date of all required documents submitted |
3 | Payment of accident insurance claims (non-fatal), health insurance, medical expenses, or critical illness benefits: | 15 days – from the date of all required documents submitted or 90 days – from the date of all required documents submitted (case in question whether the claim is under the coverage term) |
4 | Maturity | 15 days – from maturity date OR 15 days – from paid date |
5 | Dividend Payment | N/A (no dividend product) |
6 | Other Benefit Payments than surrender, premium loan, claim payment (accident insurance claims (non-fatal), health insurance, medical expenses, or critical illness benefits, maturity or dividend. | Policy Owner Service Dept. |
7 | Premium Refund by Free Look | Policy Owner Service Dept. |
4. Complaint Management | ||
1 | Acknowledging receipt of complaints via different channels such as call center, website, social media, email, any written or walk-in at HO or branches | 1 day from receiving date |
2 | Complaint review process and issuance of a decision notification that includes facts, reasons, contractual terms, or legal references. (no claim) | 30 days from complaint receipt acknowledged. |
3 | Complaint review process and issuance of a decision notification that includes facts, reasons, contractual terms, or legal references. (claim) | 3 days from the claim process completed as follows: (1) 15 days – from the date of all required documents submitted or (2) 90 days – from the date of all required documents submitted (case in question whether the claim is under the coverage term) |
# | Service | PIC |
---|---|---|
1. Underwriting and after sales services | ||
1 | Underwriting & Issuing | 3-7 days – from required documents received. (*in a case that medical information or exam needed, the company will notify the underwriting result and deliver the policy to insured within 30 days from required documents received, excluding period waiting for health information/exam result and/or other supplement documents requesting from the insured or hospital and counteroffer signed, if any*) |
2 | Policy Deliver | 5 days - from underwriting approved |
3 | Underwriting Data Submission via IBS | 30 days – from the Policy effective date |
4 | Insured’s information Change such as Name, last name or address or contact or phone or premium method | 5 days – from the date of all required documents submitted |
5 | Beneficiary Change | 5 days – from the date of all required documents submitted |
2. Policy Benefit Payment | ||
1 | Payment of accident insurance claims (non-fatal), health insurance, medical expenses, or critical illness benefits: | 15 days – from the date of all required documents submitted or 90 days – from the date of all required documents submitted (case in question whether the claim is under the coverage term) |
3. Complaint Management | ||
1 | Acknowledging receipt of complaints via different channels such as call center, website, social media, email, any written or walk-in at HO or branches | 1 day from receiving date |
2 | Complaint review process and issuance of a decision notification that includes facts, reasons, contractual terms, or legal references. (no claim) | 30 days from complaint receipt acknowledged. |
3 | Complaint review process and issuance of a decision notification that includes facts, reasons, contractual terms, or legal references. (claim) | 3 days from the claim process completed as follows: (1) 15 days – from the date of all required documents submitted or (2) 90 days – from the date of all required documents submitted (case in question whether the claim is under the coverage term) |
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