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Old 27th March 2014, 12:43   #2821
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Unhappy Re: Can Insurance claim be denied on ambiguous police diary entry?

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Originally Posted by Grr7 View Post
The claim was approved by the surveyor and the work was done at MASS. I paid for the work as the cashless facility was not available.
Thereafter I received a letter from Insurance company stating requirement of a police diary entry in the case. So, I visited police station and got a diary entry made from the police constable there This police diary was submitted to the Insurance company and after a week my insurance claim was denied stating mis-representation of the facts.
Thats totally unethical by the Insurance co. I doubt whether they knew that there would be a second entry so that they could deny the claim. The alternative is to approach the Police station to get the second entry nullified and get the copy of the first entry. Write a strong worded letter to the Insurance co of the unethical dealings and reimburse the claims. Parallely write to the Insurance ombudsman highlighting the details of the unproffessional attitude of the Insurance co. I am sure your claim will be reimbursed hopefully.
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Old 27th March 2014, 16:32   #2822
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Default Re: Can Insurance claim be denied on ambiguous police diary entry?

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Thats totally unethical by the Insurance co. I doubt whether they knew that there would be a second entry so that they could deny the claim.
Thanks for the prompt reply Ghodlur,
I had already sent a stern mail to them, but being typical govt agency, they are not ready to budge at all.
I should have got the clue from the time I went to file the claim at their office. Right from the clerk to the official were in such a pain seeing that a claim have come up on a zero dep policy for a 9+ yrs old vehicle. They even appointed a retd police inspector who visited the police station to confirm the turn of events. That retd police investigator even called me up to hint to settle the matter, but I am strictly a no bribe person.
Knowing how these police guys are, I really dont wish to visit the police station again(besides I had a little argument with the police guy who was asking some convenience charges for providing me the diary entry).
My only hope now is to approach the Insurance Ombudsman. I am attaching the replies from the Insurance office as well as the reply from PG portal for your reference.
The only thing that is putting me off is how can I be held responsible for a police diary entry that is neither my version of events nor carry my signature. If the Insurance ombudsman denies my appeal, then I think I should forget the 20k-ish claim as I would be wasting a lot of time appealing to courts and all.
Please excuse for the poor quality of pictures owing to my current location.
The first letter of claim denial
Automobile Insurance Queries? Ask me-imag0316.jpg

The second denial letter of subsequent representation:
Automobile Insurance Queries? Ask me-imag0318.jpg

Complaint to PG Portal and their reply:
Automobile Insurance Queries? Ask me-picture1.png

The email for which I never received a reply:
Name:  pic.png
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Copy pasting the letter sent by me:
To
Grievance Redressal Officer
The Oriental Insurance Co Ltd
Regional Office-1,
New Delhi-110001
05 March 2014

Dear Sir,
This is with reference to my Claim no: 270011/31/2013/036039 under Policy No: 271500/31/2013/79 for Vehicle no: DL 5CT 0034
The grievance is regarding the denial of my claim by stating some ambiguous diary entry by a police constable in the process of filing a complaint after the accident.
Sir, I am a common man who have least knowledge of the legal processes and operational procedures of Delhi Police. As stated in my earlier filed reply, I made a call to Delhi Police Control Room against the accident wherein my car suffered damage from a commercial truck with registration no HR-38N-4695 near S.B.I ATM, New Gupta Colony. Herein a investigating officer attended the complaint and I was told that there is not much I could do against the errant truck driver and I should compromise and claim my insurance to avoid legal hassles. Being a middle class man who works for his livelihood, I was (and I still am) wary of getting entangled with the complex legal proceedings and hence compromised the case on behest of the constable.
On claiming the insurance, the company surveyor inspected the damage and agreed to the extent of damage and its repair by the insurance policy which primarily included but were not limited to two broken glass panels, a damaged door panel beyond repair and few other deeply scratched/chipped paint panels. Such damage in no way could be termed “minor touching” as classified by the claim investigator/police. Besides, I feel police authorities may not be the best judge of the minor/major damage as that should, at best be left at the discretion of the insurance surveyor appointed by the company.
Further, I received a letter from Oriental Insurance that they want F.I.R/Complaint papers as issued by the Police Authorities. Since it was a straightforward honest claim of the accident and I do not have any prior experience of taking any claim (for the record, this is my first insurance claim in 10 years of ownership of my immaculately maintained car), I had not paid heed on collecting any police proceedings. Thus, after receiving the letter, I voluntarily went to the investigating officer, police station model town with the letter (Ref no: SVC/NRO2/270011/31/2013/036039) seeking the requisite information document. In reply to my request, I was asked to narrate the incident as per my memory and based on that a letter on plain paper with DD No.049B dated 16/04/2013 was issued to me by the police constable. I had the understanding that the DD no.049B was all that was required and was totally unaware if previous diary entry based on my PCR call existed as stated in your claim denial reply letter received later on. Besides, there was a time gap of almost a month between the two diary entries and some inadvertent omission while recalling the events cannot be denied of. Hence, there is some minor discrepancy regarding the identification of the vehicle involved in the accident with my vehicle (first diary entry mentions its registration number while second diary entry does not). Being a non-technical person, I honestly conveyed whatever information I could recall from almost a month old incident to the police. Both the diary entry are mere interpretation of facts as per the investigating officer. I fail to understand as to how I could be punished for the incompetency of some investigating officer who jumbled up the very facts of the complaint. I still stand to the fact that my vehicle was hit by a truck bearing registration number HR-38N-4695 (can be cross checked with phone recordings to emergency number 100) and my honest claim should be suitably honored. The driver of the said vehicle was questioned by the Police Constable and there is no way that it could be an unknown vehicle as wrongly mentioned in the diary entry 049B bearing signature of the investigating officer; the police constable investigating the complaint.
Thus, beyond any doubt, it can be summarized that:
- My car suffered some serious damage in the accident (which was wrongly designated as “minor touching” by police and rightly evaluated and work approved by your company surveyor)
- No F.I.R. was lodged because there was no damage to life and for avoiding future time consuming complex legal proceedings. Besides, complainant i.e. me cannot afford the cost of legal hassles at the cost of my livelihood.
- The goof up in identification of the vehicle involved in accident in two different diary entries is sole responsibility of investigating officer wherein both official documents bear his signature. These are police documents and I do not have any control/influence over their interpretations/outcome.
- I still stand to my statement as recorded in the PCR call at the time of accident i.e. a commercial vehicle bearing registration no. HR-38N-4695 was involved in severely damaging my car. The damaged car was duly surveyed by the company appointed surveyor and there was complete agreement to the damage caused and required repairs/replacement. All the repairs were started after getting a go ahead/approval from the surveyor.
- There is no misrepresentation of facts at any point from my side. However the non-deliberate discrepancy so discovered is due to incompetency of the police officer contradicting his own statement for which I should not be held guilty for.
Requesting you to kindly consider my grievance and please deliver a logical conclusion based on the true facts and findings of the claim.
Regards


Regards
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Old 28th March 2014, 13:10   #2823
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Default Re: Automobile Insurance Queries? Ask me

Third Party Liability rates are set to increase yet again.

Following are the new rates:

Not exceeding 1000cc - 1129
Exceeding 1000 but no 1500cc - 1332
Exceeding 1500cc - 4109

Revision-in-Motor-TP-rates-2014-15.pdf
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Old 28th March 2014, 15:11   #2824
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Default Re: Automobile Insurance Queries? Ask me

This is what is the quote I got from Honda Assure. Ok to proceed?

Automobile Insurance Queries? Ask me-city.jpg
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Old 28th March 2014, 19:58   #2825
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Default Re: Can Insurance claim be denied on ambiguous police diary entry?

Extremely sorry about your loss.


Quote:
Originally Posted by Grr7 View Post

My car met with an accident in its 9th year of ownership. A PCR call was made from the accident spot and settlement reached at the police station. My insurance policy was from The Oriental Insurance Company Ltd and was zero depreciation policy.
Can you share your policy copy? How can a 9yr old car be insured under Zero Dep? Thats not the major factor but surprising for me at least.

In your case a police report is not mandatory unless the truck is also insured with the same insurance company i.e. Oriental.
Get hold of the first FIR copy and compare with yours. I would advise go to ombudsman along with all the papers including the first FIR.

Can you share the car details and total claim approved?

The only factor against you is the double FIR. The description in both should be different which made insurance company think you are misrepresenting the facts. You cannot nullify since both are not same. What insurance company is thinking that you are trying to make a claim out of nothing and the first FIR is supporting it (even though it may be wrong)

I would once again suggest go to ombudsman asap.
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Old 29th March 2014, 01:15   #2826
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Default Re: Can Insurance claim be denied on ambiguous police diary entry?

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Originally Posted by F50 View Post
Can you share your policy copy? How can a 9yr old car be insured under Zero Dep? Thats not the major factor but surprising for me at least.

In your case a police report is not mandatory unless the truck is also insured with the same insurance company i.e. Oriental.
Get hold of the first FIR copy and compare with yours. I would advise go to ombudsman along with all the papers including the first FIR.

Can you share the car details and total claim approved?

The only factor against you is the double FIR. The description in both should be different which made insurance company think you are misrepresenting the facts. You cannot nullify since both are not same. What insurance company is thinking that you are trying to make a claim out of nothing and the first FIR is supporting it (even though it may be wrong)

I would once again suggest go to ombudsman asap.
Hey F50,

I have already shared my car policy's details on 0% depreciation thread for the benefit of other members. I am cross posting the link here where you'll find what you wish to see:
http://www.team-bhp.com/forum/indian...ml#post3223276 (0% Depreciation Insurance - It really worked for me!)

Further, sorry if I did not made myself clear. There was no FIR filed in this case, only diary entry was done on the date of accident. And a subsequent diary entry was made when I went to the police station with the insurance company's letter seeking police documents of the case(seems, the constable there was too generous to take pain of writing a new diary entry instead of making me aware that a diary entry already exists).

No, the truck in all probability was not having insurance from the same company. On second thoughts, I dont think that the truck even had an insurance policy at all.

Regarding the claim approval document, there is no such document with me. Since the workshop made a insurance claim file and told me that it is an internal file document wherein the surveyor gives approval of work to be done. Regarding the details of the work done, I shall dig up the job card tomorrow. Majorly the damage was rear door, rear door glass, front windshield glass, and other dents and paint chippings on various panels as the car was dragged for some meters and the tree guard on the footpath side scrapped the paint on the other side. Total claimed amount was some 22k. Shockingly, in Maruti's catalog, the rear door panel of zen is costlier than that of a swift.

And you are right that the discrepancy lies in the two diary entries(and not FIRs) filed by the police. But Insurance Company is willingly acting dumb here, because with a little common sense, anyone can decipher that diary entries are police documents(basically summary of events/incidents recorded by policemen for their reference) and a common citizen holds no right/influence in getting the same written in police diary.

I am approaching Ombudsman soon, but the proper channel of approach is Appeal Insurance company -> If denial, then company's grievance officer -> If denial, then Ombudsman. Currently, my appeal is pending with the grievance officer. But seeing the company person's attitude, I am not very hopeful of getting myself heard at the Grievance officer level too.

Just wish to know the technicalities of some insurance expert of how wrong is company in denying claim to me on this dual diary entry aberration grounds. And, if I, as a customer of policy be held accountable for the goof up in the diary entries filed by some incompetent policeman.

Regards
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Old 29th March 2014, 13:16   #2827
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Smile Re: Automobile Insurance Queries? Ask me

Quote:
Originally Posted by dre@ms View Post
This is what is the quote I got from Honda Assure. Ok to proceed?
Looks good to go. Get the Insurance renewed before 1st April, 2014. You can save around 400 bucks before the new TP rates are applied.

I hope you must have ensured that the premium calculations are as per the correct IDV.
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Old 29th March 2014, 14:34   #2828
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Quote:
Originally Posted by ghodlur View Post
Looks good to go. Get the Insurance renewed before 1st April, 2014. You can save around 400 bucks before the new TP rates are applied.

I hope you must have ensured that the premium calculations are as per the correct IDV.
Thanks for the reply. IDV quoted is 5,83,100. Less or Ok for a 2012 City ?
BTW, the quote is from National Insurance.
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Old 30th March 2014, 11:02   #2829
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Quote:
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IDV quoted is 5,83,100. Less or Ok for a 2012 City ?
Cant say. You can calculate if its 10% less than last year's IDV or 20% less of the current exshowroom cost of the City model/variant.
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Old 30th March 2014, 11:04   #2830
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Cant say. You can calculate if its 10% less than last year's IDV or 20% less of the current exshowroom cost of the City model/variant.
Last year the IDV was 6lacs. Should I get quote for some other insurance companies too or just renew?
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Old 30th March 2014, 11:13   #2831
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Last year the IDV was 6lacs. Should I get quote for some other insurance companies too or just renew?
Ideally your IDV should be 5.4L but based of the current exshowroom cost of the variant if the IDV is coming to 5.83L you can keep it too. Havent you tried Policybazaar.com or online quotes from Insurance co which have specifically tied up for cashless with Honda workshop? Do it ASAP.
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Old 1st April 2014, 14:13   #2832
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Default Re: Automobile Insurance Queries? Ask me

Could someone take a look at my last years insurance quotation and present renewal quotation. The IDV seems to be increasing for renewing this year over last year for the bmw secure which is the add on insurance.Also something was said about the qoute being valid until 31st march. Please advise if it's better to shift from present Bmw bajaj allianz to another insurance company instead.
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Automobile Insurance Queries? Ask me-qoute2.jpg  


Last edited by abishek2222 : 1st April 2014 at 14:29. Reason: add
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Old 1st April 2014, 16:18   #2833
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Originally Posted by abishek2222 View Post
Could someone take a look at my last years insurance quotation and present renewal quotation. The IDV seems to be increasing for renewing this year over last year for the bmw secure which is the add on insurance.Also something was said about the qoute being valid until 31st march. Please advise if it's better to shift from present Bmw bajaj allianz to another insurance company instead.
Looking at the two quotes, the IDV has dropped not increased 18.48 to 17.46L. Except that the IDV should have ideally in the 16.63L range. The quote was valid upto 31st march on the basis of the old TPL rates. Now the new TPL rates are applicable which in your case would Rs 4109. Get a revised quote and buy Insurance from Insurer who have cashless tie up with BMW workshop.
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Old 1st April 2014, 19:52   #2834
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Except that the IDV should have ideally in the 16.63L range.
Thank you sir for that response, what points can i specifically ask for like lower IDV value when i ask for quotes from other insurance companies. looking at it from my perspective after one year i still end up paying round about a lakh for last year and again this year to renew it as they have increased the cost of the addon insurance.
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Old 2nd April 2014, 08:07   #2835
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Originally Posted by abishek2222 View Post
Thank you sir for that response, what points can i specifically ask for like lower IDV value when i ask for quotes from other insurance companies. looking at it from my perspective after one year i still end up paying round about a lakh for last year and again this year to renew it as they have increased the cost of the addon insurance.
Check for premium based on correct IDV, NCB% and other discounts offered on the Insurance premium. Negotiate to get the other discounts same as last year. Also enquire with other BMW owners if you really need BMW secure add on. Wouldnt the add ons available along with the comprehensive Insurance still serve purpose. Would BMW Secure add on have its own options within?
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