Tata AIA Life Insurance Company Limited (hereinafter referred to as “the Company”) is committed to conducting business in an environment of honesty and integrity and will strive to eliminate fraud from all operations. The Company is determined to maintain a culture of strong opposition to fraud and corruption, and has a zero-tolerance approach to fraud. The Company will not accept any dishonest or fraudulent act by any employee, agent, intermediary or any other party.
Fraud Definition:As per IRDAI Circular # IRDAI/SDD/MISC/CIR/009/01/2013 on Fraud Monitoring Framework dated 21 Jan 2013, fraud in Insurance is an act or omission intended to gain dishonest or unlawful advantage for a party committing the fraud or for other related parties. The framework categorizes fraud into a) Internal Fraud, b) Policyholder Fraud and Claims Fraud, c) Intermediary Fraud, as per the IRDAI definition.
Tata AIA seeks to establish and maintain a robust framework to provide reasonable assurance that dishonest acts are prevented or promptly detected and actioned upon, which have been reinforced through Tata AIA Anti-Fraud Policy, which outlines the procedures in relation to the following:
1. Oversight:The Company has built adequate procedures and policies to oversee that the Fraud Risk Governance Framework is established, implemented and adequate internal controls exist to prevent, identify, detect, investigate, deter fraud and report insurance frauds.
2. Prevention:The Company strives towards prevention of fraud at the first place. The Company has well defined procedures to carry out due diligence on the Employee, Agents, Intermediaries, Third Party administrators, etc.. Other preventive measures such as Training and Awareness on Fraud, its implication, importance of complying with the Company’s policies & procedures, identifying/reporting of suspicious activity, are adequately laid down.
3. Detection and investigation:All employees of the Company have a responsibility to recognize potential fraud and be familiar with the types of improprieties that might occur within his/her area of responsibility. Detection techniques have been established to uncover fraud events when preventive measures fail or unmitigated risks are realized.
4. Response:The Company has zero-tolerance against any fraudulent practice, and that it is committed to ensure timely and adequate response to such event. The Company ensures that matter is investigated with its root-cause determined, appropriate action as per disciplinary matrix is timely taken, and learnings from such events are identified and implemented. The response may thus include action on fraudster, process improvements, enhanced controls, further training and monitoring etc.
5. Whistleblow avenues:The Company may receive potential fraud through tip-offs, internal/external audits, process control identification, etc. Any suspected fraud or dishonest act can be reported at either of the following:
7. Disciplinary Action:Failure to comply with the Policy will result into appropriate disciplinary action, as laid down in the Penalty Matrix for the agent/employee, Code of Conduct, or vendor agreement.