Motor Insurance Claim Process
Motor Claims arise due to accidents and theft of vehicle
What to do?
- Take spot photograph of the accident
- Obtain First Information report from police both for accident & theft
- Inform Insurance Company
- Move the vehicle to garage for repairs and obtain an estimate
- For theft claims a non traceable certificate is necessary from police authorities
- Submit claim form and repair estimate to Insurance company.
Scope of cover and documents required in the event of claims
Motor Policy- Two Wheelers
- Policy indemnifies bona fide owner of two wheeler, used for personal purposes against the loss due to damage / theft / burglary of vehicle or any part thereof, electrical accessories and also includes cover against liability towards third party personal injury and property damage.
Motor Policy- Private Car
- Policy indemnifies bona fide owner of motor car, used for personal purposes against the loss due to damage / theft / burglary of vehicle or any part thereof, electrical accessories and also includes cover against liability towards third party personal injury and property damage.
- Goods carrying vehicles
- Passenger carrying vehicles e.g. Motorized Rickshaws
- Hearses (funeral van)
- Cinema Film Recording & Publicity vans
- Mobile dispensaries etc., Tractors, Earth moving vehicles etc.
The Risk covered are
Loss or Damage to Vehicle
- Fire, explosion, self-ignition or lightning.
- Burglary, house breaking or theft.
- Riot and strike.
- Earthquake (fire and shock damage).
- Flood, typhoon, hurricane, storm, tempest, inundation, cyclone, hailstorm, frost.
- Accidental external means.
- Malicious act.
- Terrorist activity.
- Transit by road, rail, inland waterway, lift, elevator or air.
- Landslide /rockslide
Liability to Third Parties
The insurers indemnify the insured against all sums which he may become legally liable to any person including occupants carried in the motor car (provided that they are not carried for hire or reward) by reason of death or bodily injuries caused to such third parties or by reason of damage to the property of third parties caused by or arising out of the use of the motor car. The insured’s liability for damage to property of third parties is limited to Rs.6000/-; whilst liability for death of or bodily injury to third party is unlimited. the legal costs and expenses incurred by such third parties are reimbursed in addition. the legal costs and expenses incurred by the insured are also reimbursed provided that they were incurred with the insurer’s written consent. The insurers are liable for the death of or bodily injury arising out of and in the course of employment, but only to the extent necessary to meet the requirements of the motor vehicles Act. The damage to property is not paid for, if the damaged property belonged to the insured or was held in trust by him or was in the custody or control of the insured.
(Note: This section is, more or less, the same for all vehicles, subject to some variations for motor cycles and commercial vehicles)
Personal Accident Cover
There is provision for compulsory personal accident cover for owner-driver of cars and commercial vehicles of Rs.2.0 lacs and Rs.1 lac for owner driver of scooters / motorcycles. It covers death, PTD and PPD only.
- The third party premium includes cover for third party property damage in excess of the required coverage of liability of Rs.6,000/- as per the M.V.Act. In case the insured wants to get only the liability as per act covered (i.e. Rs.6,000/-) then discount in T.P. premium is allowed.
- Wider legal liability to persons e.g. paid drivers etc. employed in operation and / or maintenance of the vehicle i.e. under W.C. Act and at common law.
- Personal accident cover for unnamed passengers as per the registered carrying capacity of the vehicle upto a max. of Rs.2 lac/ person on payment of extra premium.
- Extra fittings like radios, tape-recorders, air conditioners etc. (Also applicable to commercial vehicles)
- Reliability trials and rallies in india (Also applicable to motor cycles).
Apart from claim form and survey report the other documents required for processing the claim are:
- Driving licence
- Registration certificate book
- Fitness certificate (Commercial vehicles)
- Permit (Commercial vehicles)
- Police report (Taxis, commercial vehicle need F.I.R./ spot survey if loss is heavy or T.P. loss occurs
- Final bill from repairers
- Satisfaction note from the insured
- Receipted bill from the repairer, if paid by insured.
- Discharge voucher (full and final payment)
The procedure for third party claims is briefly described as follows:
On receipt of notice of claim from the insured, or the third party or from the MACT, the matter is entrusted to an advocate. full information relating to the accident is obtained from the insured. The various documents are collected and these include:
- Driving licence
- Police report
- Details of driver’s prosecution
- Death certificate, coroner’s (PM report) report, if any for(fatal claims).
- Medical certificate (bodily injury claims)
- Details of age, income and number of dependants etc.
- A written statement is then filed on the facts of the case with the MACT by the advocate. eventually, if the award is made by the MACT, the amount is paid to the third party against proper receipt.
Depreciation on Parts for Partial Loss Claims
The following rates of depreciation shall apply for replacement of parts for partial loss claims in respect of all categories of vehicles / accessories.
- Rate of depreciation for all rubber nylon/ plastic parts, tyres and tubes, batteries and air bags - 50%
- Rate of depreciation for all fibre glass components - 30%
- Rate of depreciation for all parts made of glass - Nil
- Rate of depreciation for all other parts including wooden parts is to be as per the following schedule:
In the event of Claims being repudiated by the Insurance Company the following options are available as a recourse:
- Make a representation to the Insurance Company/TPA.
- If no reply is received within 15 days on making such representation make a representation to the Grievance Cell of the Insurance Company.
- If No Reply is received or if the reply is not satisfactory then make a representation to the Insurance Ombudsman who has Quasi Judicial powers to hear the case and make adjudication.
- If still not satisfied the next option is to go to court.