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Old 6th December 2021, 18:39   #1
RMN
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What to do when you have an insurance claim against you

Hello everyone,

Last year, my wife in her car was involved in a road accident with a lady in her scooter. The accident itself was pretty minor but then lady being aged, while she made contact with the car lost control while accelerating, spun and fell down.

My wife took the lady to the hospital and we paid her causality bills and waited for her family to arrive. By then, the results of the scan came and it showed that the lady had a fracture. Since she doesn't have any medical insurance, she asked us to pay for it. I said that wouldn't be possible and since we had a comprehensive insurance, asked her to go that route. We also paid her around 8,000rs since they did not have any cash to pay for the following days in the hospital.

They filed a case and the cops collected a FIR and in such cases a suspension in license is mandatory which my wife served. The FIR was written mostly in favor of the other lady and when I raised this concern, the cops said that's okay since the insurance will take care of it and this would help her.

After a few days we got a registered post for her settlement claim and the respondents were listed as my wife and her insurance company. From what we were told, we didn't have to respond to it since the insurance will do. I'm not sure if the insurance did or not and they have also never contacted us. A year later, we just received another registered post asking us to appear in the Nation Law Court with or without a lawyer for settlement.

At this point, I'm not sure what's going on and just wanted to check with everyone here if you are aware of what exactly my next steps should be?

Thanks a lot!

Last edited by Aditya : 11th December 2021 at 06:59. Reason: Typo
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Old 7th December 2021, 03:44   #2
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Re: What to do when you have an insurance claim against you

Contact your insurance provider and ask them if the matter has been settled from their end. Any court appearance will only be to admit guilt towards causing injury which will likely result in a fine less than 2000rs. I myself have been in a similar situation. I had to outline the accident once over the phone to my insurance service provider to confirm the claim, but never heard of license having to be suspended. If any of your friends is a lawyer, I'd ask them about it.

Last edited by IshaanIan : 7th December 2021 at 03:46.
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Old 7th December 2021, 10:10   #3
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Re: What to do when you have an insurance claim against you

Sounds bad and troublesome that the injured files FIR against the other party even after they have helped the injured and paid for hospital charges.

What would be the correct course of action to pre-empt this?
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Old 7th December 2021, 11:50   #4
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Re: What to do when you have an insurance claim against you

Quote:
Sounds bad and troublesome that the injured files FIR against the other party even after they have helped the injured and paid for hospital charges.

What would be the correct course of action to pre-empt this?
Honestly, the two poles of this conundrum are being a good human being vs saving yourself from legal trouble. My advice is to take the legal route and allow insurance to manage these circumstances if you do not have any influential connection in this country. FIR is to claim insurance money after an accident. Once the FIR is filed you will end up paying a fine in the court and move on with life. Helping on the side will only invite trouble when they start tenting in front of your house for more money and support. It sounds inhumane but when it comes to money, humanity always takes a back seat.
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Old 10th December 2021, 09:07   #5
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Re: What to do when you have an insurance claim against you

I'm curious as to why you chose to go down the insurance and FIR road. I had a friend who had something similar happen, and she ended up paying around 20k to the injured party, which included the initial check-up hospital bill. But 20k was an amount they agreed to eventually so as to avoid any police thing. I take a very dim view of the police and legal system in India, and would gladly pay whatever necessary to avoid any sort of FIR, court case, insurance claim type situation. Most people I know feel similarly. Was the initial amount of money she asked for her fracture treatment too much?
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Old 10th December 2021, 10:06   #6
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Re: What to do when you have an insurance claim against you

Hello Sir, From my limited knowledge of auditing Regional Offices of PSU Insurance Companies and more particularly, on the basis of reviewing their MACT Claim files, I would jot down the following.

There are two cases filed in case of Motor Vehicle Claim

1) FIR filed under provisions of Indian Penal Code by Police in Criminal Court. Following are provisions invoked under this case:

Section 279 IPC - Rash and Negligent driving
Section 337 IPC - hurting any person due to rash and negligent driving
Section 338 IPC - causing grevious hurt due to rash and negligent driving
Section 304A IPC - Causing death due to rash and negligent driving

In general, the punishment includes fine of few thousand rupees. Usually the accused will have to attend the court atleast three times before the judgement is passed. The normal practice is to plead guilty without any arguments as if one does not plead guilty, court may have to remand the person to judicial custody (usually 14 days) for further enquiries into the accident by police authorities.

Although imprisonement is also prescribed as a punishment, it is not generally awarded unless the driver was under the infuence of intoxicants or is proved to have committed a wilful accident or has been involved in a hit and run case.

Unless death occurs, the accused is not arrested. Even if arrested, the SHO of the Police have the power to allow table bail/station bail. This situtation is not applicable in your case as no death is involved.

2) Civil Case filed by the affected party or their dependants in Motor Accident Claims Tribunal (MACT)

This case is filed for getting compensation from the insured/insurer. Notice is served to both insured and the insurer. The insurer has the right to invoke provisions of section 170(b) of Motor Vehicle Act, 1988 to attend the case in MACT in the absence of the insured if the insured failed to respond to notice from MACT. This is the practice in almost all the MACT claim cases. The insured just does not respond to the claim. However, before deciding to not to respond to the MACT notice, insured must ensure that Insurance Ceriticate is current and valid, and other papers such as RC, Permit & FC (In case of commercial vehicles) are valid. MACT cases are disposed off after long delay which may in some cases go beyond a decade.

Hope things are clear. Pardon my language, if some terms sound very formal.
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Old 10th December 2021, 13:29   #7
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Re: What to do when you have an insurance claim against you

I am in a similar predicament,

In 2017 I was driving my friend’s ciaz from work to his home, the friend was driving his second car right in front of me.
In Mysore-Bangalore state highway a dump truck suddenly joined the stream of running traffic, this induced panic braking of a series of cars, all cars were able to brake in time with sufficient distance between each other.
However a speeding KSRTC bus couldn’t brake in time and hit the backside of the car which I was driving, it caused a series of collision in front of me, also a Dzire which was following the bus closely hit the bus and got its front damaged.
Long story short, complaint was filed with me S chief complaint and the Dzire driver as the co-complainant against the bus. After that I had completely forgotten the matter.
Just before pandemic stuck I got a call from the police station in March’20 asking me to come to court. By that time I have moved to Jaipur. Rajasthan. They were able to reach me by my mobile number only. I politely agreed and ignored. Again in Dec’21 I got a call from station asking me to attend court, rinse &repeat.

I hope this will not backfire on me.
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Old 10th December 2021, 17:46   #8
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Re: What to do when you have an insurance claim against you

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Originally Posted by adisan View Post
Sounds bad and troublesome that the injured files FIR against the other party even after they have helped the injured and paid for hospital charges.

What would be the correct course of action to pre-empt this?
Don't help the injured. Not kidding. I've been in that situation and it's not fun how everyone takes undue advantage of a random act of kindness.
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Old 10th December 2021, 17:51   #9
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Re: What to do when you have an insurance claim against you

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Originally Posted by RMN View Post
At this point, I'm not sure what's going on and just wanted to check with everyone here if you are aware of what exactly my next steps should be?

Thanks a lot!
1. Let insurance companies fight the civil case between themselves. Do not interfere.

2. For your criminal part (the complaint against your wife for causing the accident), consult a lawyer who can set a date in court, show up, pay the 2000 rupee fine or whatever it is today and be done with it once and for all.

3. Confrontation with the police, the injured, their family or really anyone else will only make matters worse, especially if you have good intentions. Don't get into it. Ignore.

Source : Personal experience.
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Old 11th December 2021, 00:53   #10
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Re: What to do when you have an insurance claim against you

Quick ques :

Was settling the case on spot not a better option in this case than dragging to insurance and all ? Because do such cases not affect the visa approval process for the person against whom the cases are registered ? Moreover having any case registered against oneself does not seem to be a good idea.

I am not giving any advice here. But want to just learn from the situation here. Hence, Eager to know thoughts of others on my queries. .

Last edited by steadfast : 11th December 2021 at 00:55.
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Old 11th December 2021, 09:57   #11
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Re: What to do when you have an insurance claim against you

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Originally Posted by VW2010 View Post
My advice is to take the legal route and allow insurance to manage these circumstances if you do not have any influential connection in this country.
Quote:
Originally Posted by shankarbn View Post
Don't help the injured. Not kidding. I've been in that situation and it's not fun how everyone takes undue advantage of a random act of kindness.
Thanks for sharing your insights and experience.

An additional question: in the event of an unfortunate incident on the road causing another party to be injured, can a person voluntarily file any kind of report with the police? Will such a step help to avoid any misrepresentations by the injured party later in time?
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Old 11th December 2021, 10:35   #12
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Re: What to do when you have an insurance claim against you

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Originally Posted by adisan View Post
Thanks for sharing your insights and experience.

An additional question: in the event of an unfortunate incident on the road causing another party to be injured, can a person voluntarily file any kind of report with the police? Will such a step help to avoid any misrepresentations by the injured party later in time?
I am also looking for an answer on this. In case we end up causing an accident (however unintentionally), can we take the initiative and report the case ourselves? If so, to whom and how? I somehow feel that it is better than waiting for the other party to come after us.
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Old 11th December 2021, 16:57   #13
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Re: What to do when you have an insurance claim against you

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Originally Posted by steadfast View Post
Quick ques :

Was settling the case on spot not a better option in this case than dragging to insurance and all ? Because do such cases not affect the visa approval process for the person against whom the cases are registered ? Moreover having any case registered against oneself does not seem to be a good idea.
You are right. FIRs in India are very tricky to get quashed once filed. FIRs get uploaded into a central database in every state, which is referred by the local police station for passport verification. So any pending FIR will have a problem during passport application or renewal.

Once filed, even local police station cannot withdraw the FIR unilaterally unless

1. The party that filed the FIR withdraws complaint. After which, police station has to follow a detailed procedure to cancel the FIR basis an investigation and report.

2. The other option is to appeal in court to quash the FIR. This process will take some time (months, years) and multiple court visits.

For visa or employment forms, it is more of a self declaration, so might not be an issue. But you would still be concealing facts and can have some repercussions in the future.

Even if you decide to pay a fine in court, take the judge order that mentions your fine , file it with the police station and get the FIR quashed.

This is the reason an FIR is now being misused by all as a form of intimidation.
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Old 11th December 2021, 20:04   #14
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Re: What to do when you have an insurance claim against you

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Originally Posted by adisan View Post
Thanks for sharing your insights and experience.

An additional question: in the event of an unfortunate incident on the road causing another party to be injured, can a person voluntarily file any kind of report with the police? Will such a step help to avoid any misrepresentations by the injured party later in time?
Nope. You cannot stop people from complaining against you. But yes, you can (and should) definitely get ahead of the issue by filing a complaint against the other party yourself. With police complaints in India, the first mover advantage is huge, as is being on either extreme of the socio economic ladder.

No matter what else you do at this point, find a scrappy lawyer and take legal advice. Nothing on this forum or elsewhere is a valid substitute for appropriate and timely legal help.

Last edited by shankarbn : 11th December 2021 at 20:09.
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Old 11th December 2021, 20:27   #15
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Re: What to do when you have an insurance claim against you

Being a decent person and covering your bases legally is not an either/or choice.

Help everyone you can in an incident, file a report with the nearest police station by stating the facts to the best of your knowledge (you don't need to prove fault one way or another at this point), get a copy of whatever is filed to avoid post-facto edits, and let them and the insurance sort out the legalities, it's their jobs. Hire a lawyer if the sequence of events is disputed or one isn't comfortable dealing with proceedings themselves.

The whole 'let me not get caught up in legal proceedings' attitude leaves one open to trouble later, and often leads to more complications compared to reporting it at the first opportunity. Even for those who'll argue they don't trust the cops, the longer you avoid involving them, the more the opportunity to muddy the waters and it turning into a one's word against another's situation.

Right after an incident, once any safety issues from the incident are dealt with, is the best time to file a formal report in good faith.

Last edited by Chetan_Rao : 11th December 2021 at 20:41. Reason: typo
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