[alpha_romeo]

Hello RJVORA,
Sometime ago I had a question on third-party insurance claims.
This incidence happened few years ago while i was returning from my office at ~11:30 pm in my own vehicle. One two-wheeler (w/o registration number) coming from opposite direction, while negotiating other vehicle skidded and hit my car near mudgaurd. Other vehicle did not bother to stop. I called police and provided medial aid immediately. After RTO inspection etc I gave my car for repairs, insurance claims etc to my Maruti dealer-insurance. Later police filed a case against me! for rash-negligent driving... I had to pay a fine of Rs 500/- in some court to come out of this police case and forwarded the police papers/reports (in local langauge) to insurance company div office as per instruction of maruti-insurance. After couple of years i got a call form insurance company divisional office regarding some third-party claims filed by someone. They had conducted investigations and found that two-wheeler rider did not even had a valid DL at the time of accident, the owner of the bike was someone else, hospital records show that the accident between two wheelar and tata-sumo (! my vehicle is maruti), as per FIR the two wheeler rider was bringing his bike from RTO office at 11:30 pm! As per instructions of insurance company and their advocate i had signed some vakalatnama and written-statments prepered by them for the defense in MACT and told me that they will take care of these claims in MACT as my documents (policy, DL, RC, etc) are in order. They told me these cases would continue for several months and i need not bother. I also cosulted with a senior adv, he told me that insurance company will fight this as these claims appears to be fraudulent.
I want to know how these claims are sorted by insurance company? Also I came across several articles (The Hindu : Tamil Nadu News : CBI to probe 7 more bogus insurance claims) where they have found fake claims. This was shocking for me.

[rjvora_2000]

Originally Posted by alpha_romeo

Hello RJVORA,
Sometime ago I had a question on third-party insurance claims.
This incidence happened few years ago while i was returning from my office at ~11:30 pm in my own vehicle. One two-wheeler (w/o registration number) coming from opposite direction, while negotiating other vehicle skidded and hit my car near mudgaurd. Other vehicle did not bother to stop. I called police and provided medial aid immediately. After RTO inspection etc I gave my car for repairs, insurance claims etc to my Maruti dealer-insurance. Later police filed a case against me! for rash-negligent driving... I had to pay a fine of Rs 500/- in some court to come out of this police case and forwarded the police papers/reports (in local langauge) to insurance company div office as per instruction of maruti-insurance. After couple of years i got a call form insurance company divisional office regarding some third-party claims filed by someone. They had conducted investigations and found that two-wheeler rider did not even had a valid DL at the time of accident, the owner of the bike was someone else, hospital records show that the accident between two wheelar and tata-sumo (! my vehicle is maruti), as per FIR the two wheeler rider was bringing his bike from RTO office at 11:30 pm! As per instructions of insurance company and their advocate i had signed some vakalatnama and written-statments prepered by them for the defense in MACT and told me that they will take care of these claims in MACT as my documents (policy, DL, RC, etc) are in order. They told me these cases would continue for several months and i need not bother. I also cosulted with a senior adv, he told me that insurance company will fight this as these claims appears to be fraudulent.
I want to know how these claims are sorted by insurance company? Also I came across several articles (The Hindu : Tamil Nadu News : CBI to probe 7 more bogus insurance claims) where they have found fake claims. This was shocking for me.

Sad as well as shocking to know your story.

"Later police filed a case against me! for rash-negligent driving" - Sad to know this.

"valid DL" , "One two-wheeler (w/o registration number)" Without RC is something strange.

People do that I know. making fraud claim's is not new for insurance company. This cashless service, Taking photo's while surveying the car etc. all this is done to stop frauds but still does that mean that there are no frauds happening in insurance company today? If you think yes then we may be wrong. I am seeing today also that they are doing wrong but still can't stop that.

One of the reason why I say one should to insure with Pvt. companies is this also. I am not saying that there they don't fraud or any thing but chances are less compare to government company.

[csentil]

Most of the insurance frauds don't have anything to do with the Insurance companies. Its a typical nexus between the cops and the RTO. Some accident happens and even if its a hit and run, the cop registers a case, the RTO approves it and a claim is made. There have been cases where everything has been setup.

[rshiv]

I assume Insurance business model works the same way the credit card works! 25% of good clients covers the 50% of the fraudsters claims. I also believe the claims and settlements are more of happenings in a known process cycle. All the players in loop know the moves well.

[rjvora_2000]

Originally Posted by csentil

Most of the insurance frauds don't have anything to do with the Insurance companies. Its a typical nexus between the cops and the RTO. Some accident happens and even if its a hit and run, the cop registers a case, the RTO approves it and a claim is made. There have been cases where everything has been setup.

Your statement is true but in case of TP claim, I think insurance surveyor's also play an important part when it come's to small claim's.

[alpha_romeo]

For TP claim cases, as per my experience everything is decided by the insurance company or MACT. Insurance company officers and panel lawyers take all the decisions to settle the claims in MACT/out-of-court. So I guess it is not decided by a single person. What I heard is, they have specific formulas to asses the loss as per IRDA. These are complicated, so normally insurance people handle these as they have been trained to handle such cases. Paperwork would depend on the insurance company which is handled by compitent agent or broker.

[rjvora_2000]

Originally Posted by alpha_romeo

For TP claim cases, as per my experience everything is decided by the insurance company or MACT. Insurance company officers and panel lawyers take all the decisions to settle the claims in MACT/out-of-court. So I guess it is not decided by a single person. What I heard is, they have specific formulas to asses the loss as per IRDA. These are complicated, so normally insurance people handle these as they have been trained to handle such cases. Paperwork would depend on the insurance company which is handled by compitent agent or broker.

Yes you are right!!

Tp is totally handled by insurance company, they have a separate department which take's care of TP. There are experts in that department which know and understand the law well.

[sam003]

I am posting this on my friends behalf.
He just purchased second hand car. First owner has paid insurance for whole year and its running on no claim till today. So when my friend contacted Insurance agent, he said if you pay some amount of No claim say 1000/- then you can be eligible for claiming on that insurance. I am not sure how this can happen.

[rjvora_2000]

Originally Posted by sam003

I am posting this on my friends behalf.
He just purchased second hand car. First owner has paid insurance for whole year and its running on no claim till today. So when my friend contacted Insurance agent, he said if you pay some amount of No claim say 1000/- then you can be eligible for claiming on that insurance. I am not sure how this can happen.

Sorry for the delay in reply, as I was out of station.

Please pay this amount as this is a transfer charges from seller's name to your friend's name. You will have to pay this amount.

currently the car is in the name of your friend (RC book) and the policy is in the name of the seller. - This is wrong!! Right!!

[Spinnerr]

Originally Posted by csentil

a. having an Anti Theft Device installed (2.5% or max of 500)

Can some one confirm this? I am being offered only 2.25% for Anti Theft device.

Insuring with ICICI Lombard
IDV: 5,50,000
Rate: 2.408
NCB: 20%
Anti Theft: 2.25%

Final Premium: 14,520

[rjvora_2000]

Originally Posted by Spinnerr

Can some one confirm this? I am being offered only 2.25% for Anti Theft device.

Insuring with ICICI Lombard
IDV: 5,50,000
Rate: 2.408
NCB: 20%
Anti Theft: 2.25%

Final Premium: 14,520

Is it still less then Rs. 500/-?

Talk to IcIcI people you will get refund of premium if they have taken extra.

[Spinnerr]

Yes, it is less than Rs 500.
Rs 334.

Would they refund in this case? Is 2.5% for Anti-theft device a fixed standard rate? else is it something variable that can go as high as 2.5 or Rs500?

[rjvora_2000]

Originally Posted by Spinnerr

Yes, it is less than Rs 500.
Rs 334.

Would they refund in this case? Is 2.5% for Anti-theft device a fixed standard rate? else is it something variable that can go as high as 2.5 or Rs500?

2.5% or Maximum Rs. 500/-

[NK@Hyd]

I received my car insurance certificate from HDFC Ergo yesterday with a few discrepancies, will appreciate your advice:

-The cubic capacity of my Magna i10 is 1197cc while it is mentioned as 1087cc in the certificate. I called them up, they admitted and said that since premium amount would not change (I think there is a slab for 1000cc-1600cc cars), they would not send a fresh insurance certificate; instead they would just send an endorsement letter stating that the car is 1197cc (and correct this in their system too). Also,that since they would correct it in their system, the premium renewal receipts will carry the correct cubic capacity (if at all, there's a field for cubic capacity).Do you foresee any problems with this, possiblities: in case my car papers are checked anytime during an accident or during regular checking or if I want to sell the vehicle after, say, 5 years?

-The premium mentioned in the certificate is almost 1000 bucks less than what I was charged by the car dealer. The insurance premium was a component of the car price in their price list(then mentioned as Bajaj Allianz's insurance) which I duly paid, but now I see that HDFC Ergo's premium is a bit less and even confirmed that they received only the amount mentioned on the certificate from the dealer . Do the dealers charge a bit more as their commission on it? Regardless, I would confront them with this issue.

Thanks!

[rjvora_2000]

Originally Posted by NK@Hyd

I received my car insurance certificate from HDFC Ergo yesterday with a few discrepancies, will appreciate your advice:

-The cubic capacity of my Magna i10 is 1197cc while it is mentioned as 1087cc in the certificate. I called them up, they admitted and said that since premium amount would not change (I think there is a slab for 1000cc-1600cc cars), they would not send a fresh insurance certificate; instead they would just send an endorsement letter stating that the car is 1197cc (and correct this in their system too). Also,that since they would correct it in their system, the premium renewal receipts will carry the correct cubic capacity (if at all, there's a field for cubic capacity).Do you foresee any problems with this, possiblities: in case my car papers are checked anytime during an accident or during regular checking or if I want to sell the vehicle after, say, 5 years?

-The premium mentioned in the certificate is almost 1000 bucks less than what I was charged by the car dealer. The insurance premium was a component of the car price in their price list(then mentioned as Bajaj Allianz's insurance) which I duly paid, but now I see that HDFC Ergo's premium is a bit less and even confirmed that they received only the amount mentioned on the certificate from the dealer . Do the dealers charge a bit more as their commission on it? Regardless, I would confront them with this issue.

Thanks!

1. C.C. problem - As insurance company has told you that they will issue the endorsement. That will not be a problem of any king to you in feature. Make sure you receive the correct endorsement and keep that paper with you.

2. Dealer Charging High - This is what you should do to a dealer.

Normal case most of the people don't check their policy and such silly mistakes are not noticed by the owner's. Tell your dealer you will go to police station against him if he does not refund you the amount.

I believe you should fight if you are right. (You may not go to police station but still tell him that you will go and see your work happening very fast.)

There are no such charges which a dealer can charge for insurance.