As per Surveyor Regulation 2015- CHAPTER IV DUTIES AND RESPONSIBILITIES OF A SURVEYOR AND LOSS ASSESSOR 13. It shall be the duty of every Licensed Surveyor and Loss Assessor to investigate, manage, quantify, validate and deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or insured, as the case may be., All Licensed Surveyors and Loss Assessors shall carry out the said work with competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these Regulations.
सर बहुत बहुत धन्यवाद आपका जो आपने हमे ये जानकारी दी। मेरी गाड़ी भी एक्सीडेंट हुई थी। सर्वेयर साहब भी mughe यही बात कह रहे है की investigetion लगा है।कोई inqari नही मेरी गाड़ी को डेढ़ महीना हो गया है । मेरी comrceal गाड़ी है किस्त मै घर से भर रहा हु।मै गरीब आदमी हु ।मेरा परिवार गाड़ी की कमाई से चलती है। मै क्या करू सर। बहुत parishan हु। प्लीज
हद से ज्यादा भ्रष्टाचार:- आजकल के समय मे हमारे देश में मोटर बीमा पैकेज बीमा पालिसी के अंतर्गत मोटर od claim विषय में CTL/TL claim case में, सैटलमैट करने के तरीके मे बहुत बहुत अधिक भ्रष्टाचार चल रहा है। यह भ्रष्टाचार बहुत ही खुलेआम हो रहा है। यहां तक कि यदि इस विषय मे बीमा धारक ग्राहक की और से बीमा कंपनी व बीमा नियामक- IRDAI को शिकायत की जाती है तो भी अधिकांश मामलों में कुछ हासिल नहीं हो पाता है। कोई सुनवाई ही नहीं होती है। मोटर पैकेज बीमा पालिसी, जैसे निजी कार पैकेज बीमा पालिसी, मे एक condition no. 03 होती है। बीमा पालिसी की condition 03 मे क्लेम सैटलमैट करने के लिए 02 तरीके दिये होते है। एक तो CTL/TL claim case व दुसरा अन्य सभी- partial loss claim. बीमा पालिसी अनुबंध की शर्त 03 मे लिखा होता है कि बीमा कंपनी के पास क्लेम सैटलमैट भुगतान करने के लिए मुख्यतः 03 विकल्प होते है। A, repair reinstate. वाहन की मरम्मत करके बहाल करने का। B, Replacement of vehicle or parts accessories... वाहन को replacement करके, या पार्टस accessories को replacement करके। ( Note:- यहाँ पर पुराने वाहन या पुराने पार्टस के लिए नहीं लिखा हुआ है। यह शर्त नये वाहन या नये parts के लिए होती है, अलबत्ता यदि बीमा धारक ग्राहक की मर्जी है तो वह इसे पुरानी गाड़ी के बदलाव या पुराने पार्टस के बदलाव के साथ भी इस शर्त को अपना सकता है, लेकिन इसके अंतर्गत, पुराने के बदलाव लिए, बीमा धारक ग्राहक पर दबाव नहीं डाला जा सकता है।) C, pay the cash amount of loss or damage. बीमा पालिसी अनुबंध की शर्त 03 में, मोटर बीमा OD claim के लिए बीमा कंपनी की liability को तैय करने का नियम दिया होता है। इसमे liability तैय करने के लिए 02 तरीके दिये होते है। a, जो क्लेम केस total loss या constructive total loss के दायरे मे आते है। constructive total loss की परिभाषा, G.R. 08 के अनुसार होती है। उनमें बीमा कंपनी की अधिकतम liability, गाड़ी की IDV - less wreck value, terms and conditions के तहत होती है। b, CTL/TL claim case के अलावा सभी केस partial loss क्लेम केस होते है। इसमे बीमा कंपनी की liability, actual and reasonable costs of repair or replacement subject to terms and conditions of policy होती है। Findings:- 1, यहाँ पर total loss व constructive total loss सैटलमैट करने के लिए IDV - Wreck value को लिखा हुआ है। आप यदि जानना चाहे तो dictionary मे देख सकते है कि wreck का मतलब क्या होता है। wreck का मतलब कबाड़ ही होता है। Wreck value का मतलब बिलकुल भी, गाड़ी के रूप मे transfer करके बेचने से प्राप्त value से नहीं होता है। 2, यहाँ सिर्फ दो तरीके के क्लेम सैटलमैट तरीके दिये है। CTL/TL claim case Partial loss claim case. 3, Total loss claim व Constructive total loss सैटलमैट करने के लिए तरीके मे कोई भी फर्क नहीं दिया हुआ है। दोनों को सैटलमैट करने का तरीका एक ही है। सार :- कुल मिलाकर मेरा कहना यह है कि निजी क्षेत्र की अधिकांश साधारण बीमा कंपनी, constructive total loss, क्लेम केस को गलत तरीके से, गाड़ी साल्वेज को एक गाड़ी के रूप मे बिकवाकर, गलत तरीके से क्लेम को सैटलमैट कर रही है। और सबसे महत्वपूर्ण बात यह है कि यह कार्य इतनी धूर्तता के साथ करती है कि इस तरीके के क्लेम सैटलमैट के लिए, बीमा धारक ग्राहक को लिखित मे क्लेम सैटलमैट आफर लैटर जिसमे अपनी जिम्मेदारी सहित क्लेम सैटलमैट तरीके को लिखकर दे, लिखित मे देकर नहीं करती है। उल्टा बीमा धारक ग्राहक को एक consent format देकर, जबरदस्ती धूर्तता के साथ, उससे उसकी मर्जी पसंद के अनुसार यह विकल्प की चाहत को लिखवाकर ले लेती है। ताकि यदि कभी भविष्य में कोई कानूनी मामला आये तो उससे बीमा कंपनी साफ साफ बच जाय, बीमा कंपनी कह सके कि हमने तो यह तरीका बीमा धारक ग्राहक के कहने पर उसकी चाहत पसंद के अनुसार किया है। इस प्रकार के गलत कार्य मे अक्सर कुछ चुनिंदा एप्रूवड सर्वेयर भी बीमा कंपनी का साथ देते है, जो कि बहुत दुर्भाग्यपूर्ण है। इस प्रकार की गाड़ी के तौर पर बिकी salvage का अक्सर चोरी की गाड़ी मे इस्तेमाल होता है। आप अक्सर अखबार मे इस तरीके की खबरों को पढ़ सकते है। वैसे irdai ने भी इसके लिए सभी साधारण बीमा कंपनी को advisory जारी की हुई है कि सभी बीमा कंपनी total loss claim मे गाड़ी की rc को निरस्त करके क्लेम सैटलमैट करे। लेकिन यहाँ अधिकांश निजी क्षेत्र की साधारण बीमा कंपनी पर इसका कोई फर्क नहीं पड़ रहा है। इन अधिकांश बीमा कंपनी के अधिकारी कर्मचारी ने constructive total loss के लिए अपनी अपनी पसंद मर्जी के अनुसार परिभाषा बना रखी है व उसे ही अमल मे ला रहे। यह सब कुछ बहुत ही खुलेआम चल रहा है। वास्तव मे यह बहुत ज्यादा निराशाजनक है। STANDARD FORM FOR PRIVATE CAR PACKAGE POLICY :- Policy condition 03- 3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and """the liability of the Company shall not exceed""": (a) """"for total loss / constructive total loss of the vehicle"""" - the Insured's Declared Value (IDV) of the vehicle (including accessories thereon) as specified in the Schedule ""less the value of the wreck"". (b) ""for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle""" - actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified. अशोक कुमार सिंह, ग्रेटर नोएडा, उत्तर प्रदेश। 20.11.2021.
What is the role of an investigator in an insurance company? An insurance investigator is an individual who inspects and researches an insurance claim to ensure no fraud is occurring. They gather information from the insurance adjuster , law enforcement, claimant and witnesses in order to develop a better understanding of the case and decide whether the claim is valid
As per Surveyor Regulation 2015.. CHAPTER IV DUTIES AND RESPONSIBILITIES OF A SURVEYOR AND LOSS ASSESSOR 13. It shall be the duty of every Licensed Surveyor and Loss Assessor to """"investigate""", manage, quantify, validate and deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or insured, as the case may be., All Licensed Surveyors and Loss Assessors shall carry out the said work with competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these Regulations.
82. For section 64UM of the Insurance Act, the following section shall be substituted, namely:- ‘64UM. (1) Save as otherwise provided in this section, no person shall act as a surveyor or loss assessor in respect of general insurance business after the expiry of a period of one year from the commencement of the Insurance Laws (Amendment) Act, 2015, unless he- (a) possesses such academic qualifications as may be specified by the regulations made under this Act; and (b) is a member of a professional body of surveyors and loss assessors, namely, the Indian Institute of Insurance Surveyors and Loss Assessors: Provided that in the case of a firm or company, all the partners or directors or other persons, who may be called upon to make a survey or assess a loss reported, as the case may be, shall fulfil the requirements of clauses (a) and (b). (2) Every surveyor and loss assessor shall comply with the code of conduct in respect of his duties, responsibilities and other professional requirements, as may be specified by the regulations made under the Act. (3) Notwithstanding anything contained in the foregoing provisions, a class or class of persons acting as a licensed surveyor or loss assessor prior to the commencement of the Insurance Laws (Amendment) Act, 2015 shall continue to act as such for such period as may be specified by the regulations made under this Act: Provided that the surveyor or loss assessor shall, within the period as may be notified by the Authority, satisfy the requirements of clause (a) and clause (b) of subsection (1), failing which, the surveyor or loss assessor shall be automatically disqualified to act as a surveyor or loss assessor. (4) No claim in respect of a loss which has occurred in India and requiring to be paid or settled in India equal to or exceeding an amount specified in the regulations by the Authority in value on any policy of insurance, arising or intimated to an insurer at any time after the expiry of a period of one year from the commencement of the Insurance Laws (Amendment) Act, 2015, shall, unless otherwise directed by the Authority, be admitted for payment or settled by the insurer unless he has obtained a report, on the loss that has occurred, from a person who holds a licence issued under this section to act as a surveyor or loss assessor (hereafter referred to as "approved surveyor or loss assessor"): Provided that nothing in this sub-section shall be deemed to take away or abridge the right of the insurer to pay or settle any claim at any amount different from the amount assessed by the approved surveyor or loss assessor.
Total loss is pure harassment. Showroom will charge you on daily basis. And insurance settlement may take 3-4 months including RC cancellation. RC cancellation is much tough process. It is really harrasment by insurance company.
car m air bag damage h aur agar car ka claim reject ho jaye, to grievance submit krne k baad. Car ko service centre pr rehne de ya wapas le k aa jaye ???? Service centre pr charges lagege insurance claim reject hone k baad aur grievance ka reply aane m time lagega kuch bataye kya karu, car running condition m h
Sir I have a question.after my car accident surveyor gave work approval for repair of car.but after giving work approval I got a call from insurance company that there will be a investigation.investigator came and did the investigation.report not came. Now, my question is that after giving approval by surveyor via mail why investigation is happening. Is there a chance to reject my claim by insurance company? Surveyor mailed body shop to start the repair work.
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
यदि कोई बीमा पालिसी अनुबंध का उल्लंघन होगा तो बीमा कंपनी क्लेम देने से मना कर सकती है। बीमा कंपनी मे एक शर्त right to recovery भी होता है यदि बीमा कंपनी ने किसी वजह से आपको कोई बीमा क्लेम गलती से दे दिया और बाद मे बीमा कंपनी को यह गलती का पता चलता है, तब बीमा कंपनी right to recovery के अधिकार से पहले हुए गलत भुगतान को वापस मांग सकती है, यदि कोई न दे तो इसके लिए court में जा सकती है। वैसे किसी साधारण बीमा क्लेम मे एप्रूवड सर्वेयर की सर्वे रिपोर्ट बहुत अधिक मायने रखती है। एप्रूवड सर्वेयर का काम investigation का भी होता है। लेकिन सामान्यतः बीमा कंपनी, जिन्हें Investigator के तौर पर नियुक्त करती है, अधिकांश ये सिर्फ पेपर्स, statements एकत्र करके बीमा कंपनी तक पहुँचाने वाले होते है। वैसे बीमा कानून मे अलग से Investigator कोई legal entity नहीं होता है। इसलिए इनके लिए कोई duties and responsibilities:-, code of conduct तैय ही नहीं है। यदा कदा ये बहुत से बीमा धारक ग्राहक के क्लेम को delay करने के लिए या unnecessary harrassment करने के लिए इस्तेमाल किये जाते है। एक तरीके से इन्हें आप बीमा कंपनी का हिस्सा ही मान सकते है। लेकिन protection of policy holders interest gazette notification 2017, मे बीमा नियामक ने General insurance claims के लिए guidelines तैय की हुई है। आप उसे पढ़ कर अपनी बीमा कंपनी से सवाल पूछ सकते है।
आप बीमा कंपनी के officials व Chief Grievance officer को ईमेल करके इस विषय मे शिकायत कीजिये। आप हिंदी English या जो भाषा भी आपको आती है, उस भाषा मे शिकायत कर सकते है। आप को पूछना है कि इतना लंबा समय बीत गया है आपने अभी तक यह क्लेम क्यों नही settle किया है। आप लिखना कि यह side मे बैठे व्यक्ति का खुन का blood group नहीं मिल रहा है जैसा बीमा कंपनी आपको बता रही है, ऐसा क्यों है यह आप नहीं जानते है कि ऐसा क्यों है। आप सिर्फ इतना जानते है कि यह दुर्घटना हुई थी। यह व्यक्ति गाड़ी चला रहा था, और गाड़ी मे ये व्यक्ति दुर्घटना के समय मौजूद थे। आप बिलकुल सच व सही दुर्घटना का कारण, मतलब विस्तार से दुर्घटना होने को लिखकर भी भेजना। आप लिखना की आप बीमा कंपनी से इस क्लेम विषय में संतुष्ट नहीं है। आप इस क्लेम केस की सर्वे रिपोर्ट कापी बीमा कंपनी व एप्रूवड सर्वेयर दोनों से लिखित मे मांगना। यह शिकायत को मै आपको कुछ email I'd साझा कर रहा हूँ,उन्हें भी बीमा कंपनी के साथ साथ रखना। हर अपनी शिकायत का जबाब लिखित में मांगना। अगर बीमा कंपनी क्लेम नो क्लेम करने का मन बना रही है तो यह पूछना की बीमा पालिसी अनुबंध कि किस specific terms and conditions के तहत no claim करने के बारे मे सोच रही है। बीमा कंपनी को लिखना की क्लेम सैटलमैट का समय, protection of policy holders interest gazette notification 2017 मे अनुसार काफी कम होना चाहिए था, लेकिन बीमा कंपनी उन guidelines का पालन नहीं कर रही है ऐसा क्यों। और जो भी आपको शिकायत है points मे 01,02, 03 आदि करके लिखना। उम्मीद करता हूँ कि आपको परिणाम मिल जाना चाहिए।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
25/11/2021 को हुंडई शोरूम से गाड़ी ली थी और 25 /11/2021 को ही RTO और इंसोरेंस के रूपये वही शोरूम में डिपॉजिट कर दिए थे। लेकिन 29/11/2021 को गाड़ी का रजिट्रेशन किया गया था और 27 /11/2021गाड़ी accidents हो गई। अब इंसोरेंस कम्पनी ने नो क्लेम कर दिया है ।अब मुझे क्या करना चाहिए। कृपया उचित सलाह दे ।🙏🙏
हमारी गाड़ी 17 को एक्सीडेंट हुयी थी पर हम उसे वर्कशॉप मे 25 को ले गये और एजेंसी के वर्कशॉप सुपरवाइजर नें बोला की आप 20-21 का लिखवाओ नहीं तो ज्यादा पुराना केस बताकर क्लेम रिजेक्ट हो जायेगा, इसीलिए हमने 21 लिख दिया, जबकि मै 21 का ड्यूटी मे था, अब कैसे बात बने please help me sir
hello sir, sir my issue is, i met an accident on 6th feb 2022 and intimation to insurance company was done on 15th feb 2022, at that time estimate was made more than 75% of the IDV value and the surveyor told me that car will go in total loss and said it will take around one month, but not after 2 months surveyor is saying that we will repair the car and total loss will not be there. but now i have booked another car. what should o do now ?
As per IRDAI book:- (2). What is the need to engage an Insurance Surveyor ? """""" The need for the engagement of a surveyor is for assessing the loss/damage suffered without any bias or prejudice and by a ""professional/expert"" in the field"""" . (3). """ If the surveyors are appointed by the insurance company, do they favour insurance companies"""? """ This is a false notion that surveyors are the representatives of insurance companies and so they favour insurers""". A surveyor and loss assessor shall act impartially and maintain confidentiality, neutrality without jeopardizing the liability of the insurer and the claim of the insured. (4). Is the loss amount assessed by surveyor binding on insurer/s? No. The insurers are not bound by the loss amount assessed by the surveyor. The insurer has the right to pay or settle any claim at any amount different from the amount assessed by the appointed surveyor.
As per Surveyor Regulations 2015-20. CHAPTER IV DUTIES AND RESPONSIBILITIES OF A SURVEYOR AND LOSS ASSESSOR 13. It shall be the duty of every Licensed Surveyor and Loss Assessor to investigate, manage, quantify, validate and deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or insured, as the case may be., All Licensed Surveyors and Loss Assessors shall carry out the said work with competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these Regulations. (1) The following, shall, inter alia, be the duties and responsibilities of a Surveyor and Loss Assessor:- (c) maintaining confidentiality and neutrality without jeopardising the liability of the insurer and claim of the insured; (i) Reg 20-(i) Commenting on the admissibility of the claim and assessing the liability of the insurer as per the policy terms and conditions. (m) satisfying queries of the insured/insurer and of persons connected thereto in respect of the claim/loss; (o) giving reasons for repudiation of claim, in case the claim is not covered by policy terms and conditions; (2) A surveyor or loss assessor whether appointed by insurer or insured, shall submit his report to the insurer as expeditiously as possible, but not later than 30 days of his appointment, with a copy of the report to the insured giving his comments on the insured’s consent or otherwise on the assessment of loss. Where, in special circumstances of the case, either due to its special and complicated nature, the surveyor shall under intimation to the insured, seek an extension, in any case not exceeding six months from the insurer for submission of his report.
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Rule:- General Regulations 08 as per Indian Motor Tariff:- The Insured‟s Declared Value (IDV) of the vehicle will be deemed to be the „SUM INSURED‟ for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle. A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and / or repair """of the vehicle"""" subject to terms and conditions of the policy exceeds 75% of the IDV.
बीमा कानून के अंतर्गत सर्वेयर रेगुलेशन 2015-20 के अनुसार, मोटर OD claim में, तैय प्रकार के 50 हजार से ज्यादा के बीमा क्लेम केस में एक एप्रूवड सर्वेयर को नियुक्त करना अनिवार्य आवश्यक होता है। एप्रूवड सर्वेयर, सर्वेयर रेगुलेशन 2015-20 में तैय नियमों का पालन करते हुए निष्पक्षता व संबंधित बीमा विशेषज्ञता के साथ दुर्घटना क्लेम गाड़ी का सर्वे निरिक्षण करता है, व independently नुकसान आकलन व अनुशंसा करता है। एप्रूवड सर्वेयर के नुकसान आकलन व अनुशंसा कार्य मे बीमा कंपनी का कोई हस्तक्षेप नहीं होता है। एक एप्रूवड सर्वेयर क्लेम सैटलमैट विषय पर निर्णय नहीं लेता है वह सिर्फ नुकसान आकलन व अनुशंसा कर सकता है। लेकिन अधिकांशतः हमारे देश मे एप्रूवड सर्वेयर, बजाय निष्पक्षता व संबंधित बीमा विशेषज्ञता के, बीमा कंपनी की मर्जी पसंद दिशा निर्देश आदेश के अनुसार नुकसान आकलन व अनुशंसा करते है। मोटर बीमा पालिसी अनुबंध के अनुसार कोई भी गाड़ी CTL/TL claim तब होती है, जब वाहन का Aggregate repair cost वाहन की IDV के 75% से ज्यादा हो। बहुत से लोग इसे भी गलत तरीके से बजाय वाहन के Aggregate repair cost के 75% of IDV से अधिक होने की जगह बीमा कंपनी की Net liability on repair basis के 75% of IDV से अधिक होने को CTL/TL claim case का आधार मानते है। वैसे जुबानी बातो का कोई आधार नहीं होता है। आप बीमा कंपनी से interim survey report copy की मांग कर सकते है। protection of policy holders interest gazette notification 2017 के अनुसार यह 15 दिनों के अंदर अंदर बीमा कंपनी को बीमा धारक ग्राहक के मांगने पर देनी होती है।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
मेरा इस विषय मे बहुत ही स्पष्ट मानना है। हो सकता है आपका मानना मुझसे भिन्न हो। यह हो सकता है। मेरा इस विषय में कोई सवाल पूछा ही नहीं है। मैंने यहाँ इस video मे अपनी बातों को रखा है। जिस बीमा क्लेम का मै यहाँ उदाहरण दे रहा था, जब बीमा कंपनी व एप्रूवड सर्वेयर साहब को इस विषय मे मेरी इन्ही opinion के अनुसार ईमेल की गयी। तो एप्रूवड सर्वेयर साहब व बीमा कंपनी दोनो ने बीमा धारक ग्राहक को सर्वे रिपोर्ट कापी दी। बीमा कंपनी ने claim settlement offer letter दिया व बीमा कंपनी ने बीमा धारक ग्राहक को पुरा पुरा क्लेम दिया। और यह सब भी 03- 04 दिनों के अंदर मे हुआ। ईमेल करने के बाद बीमा कंपनी की तरफ से बीमा कंपनी के वरिष्ठ अधिकारीगण व एप्रूवड सर्वेयर साहब के फोन भी बीमा धारक ग्राहक को आने लगे थे। जबकि पहले ये कोई बात नहीं करते थे। जीवन मे विभिन्न लोगो का एक ही विषय पर मानना भिन्न भिन्न हो सकता है, इस विषय में explanations अलग अलग हो सकती है। आपका जो कुछ भी मानना है आपको जो कुछ भी सही लगता है, आप उस पर कायम रहिये। आप मेरे इस video message की बातो को ignore कर दीजिये। इसी प्रकार मेरा जो मानना है मैंने उसी के अनुसार यह video message बनाया है। आपने मुझे जबाब लिखा इसके लिए आपका बहुत-बहुत धन्यवाद।
Sir, my scooter was stolen on 8th April, 2022 and now the surveyor told me i should have received a mail from Insurance Company. I told him I didn't receive any so he asked me to call the customer care. Then they gave me Claim Department number, I called them he said they have received the report from Surveyor and they'll review the report and it'll take 3-4 months. So what should I do now ? Please tell🙏
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Insurance company says claim is closed because court's A summary report was not provided ... After court give A summary report is submitted that report to insurance company but they are saying your claim is closed they are not receiving calls it's very depressing.... What should I do ?
I am sharing one irdai circular in this regard, Ref. No:IRDA/NL/CIR/MISC/149/06/2017 Date:28-06-2017Delay in Claim Intimation/Documents Submission. The Authority, vide circular no.IRDA/HLTH/MISC/CIR/216/09/2011 dated 20.09.2011, issued guidelines as to how to deal with delayed intimation of claims and """delayed submission of documents""" by the claimants. Since, some insurance companies were not adhering to the provisions of the circular, the Authority further issued directions under section 34(1) of the Insurance Act, 1938, vide no.IRDA/NL/MISC/CIR/214/10/2016 dated 28.10.2016 clarifying that the circular dated 20.09.2011 is binding on the insurers. Recently, in a legal case the Hon’ble High Court, while passing the order made several adverse comments against the Insurance Companies’ non-compliance of the Authority’s direction and ordered the Authority to take appropriate remedial measures. In view of the above, you are hereby advised to ensure compliance with the said circulars scrupulously. (P.J.Joseph) Member (Non-Life)
आप बीमा कंपनी को इस उपरोक्त irdai circular के साथ बीमा क्लेम को reopen करने के लिए व क्लेम देने के लिए ईमेल कर दीजिये। वैसे भी यह court की report को जारी करना आपके अधिकार क्षेत्र मे नहीं था।
Sir meri gadi total loss me gayi oct 20 ko and driver ka death bhi hua and sare formalities ho gyi even meko offer letter bhi aaya but jiss time pe paise transfer krni thi uss time driver ke brother ne company ko mail kiya ki uske bhai ne gadi drive ni ki. Ab iss baat ko 3 month ho gye maine police ki final report bhi submit kr di hai. Uske baad bhi claim settle nahi ho raha. even investigation 3 month se chal raha. Please help me mai kya karu
Sir Mera car accident hua 10th sep ko Maine show room gaadi dediya magar insurance vaale claim nahi kar rahe he aur zung lagne ki baje se kehrahe ki purani accident hai hum claim nahi karte
Hello Sir, my claim was put into investigation wherein I had provided all photos ,videos of accident spot where in I am standing in injured condition with the car. But still it has gone for investigation. And Maruti Nexa held my loaner car request saying that as per policy the can not provide the loaner car until they recieve the final approval after investigation. I m feeling mentally harrassed. Please help..
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
@@motorinsuranceclaimspracti4142 the surveyor has done the survey successfully, and company estimate is also finalised, further insurance head asked for investigation, and that investigation is being delayed from 1 week
Dear Sir My car was stolen on 3rd of Feb 2022. My car was only 11 months old and I have valid insurance which will expire on 08 March 2022. So my question is that the car was registered on my wife's name and FIR is lodged by my younger brother. So could you please confirm if this will create an issue while settling the claim? Secondly I don't have PUC of concern vehicle, so please suggest me if this will be a issue for settlement?
Meri gaadi ka accident hua tha march ko usme driver ki death bhi ho gyi thi. Car bhi total loss mei hai. Abh tak 6 month ho gye hai iska investigation hui hai or sare documents bhi laga diye hai file mei but process insurance office mei hi latka hua hai. Manager roz naye naye kaam bta deta hai ye leke aao wo leke aao. Yr pareshan karke rakha hai. Abhi tak claim ka kuch pta nhi chal raha
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
बीमा क्लेम सैटलमैट के विषय मे बीमा नियामक ने उपरोक्त प्रक्रिया को तैय किया हुआ है। क्लेम सैटलमैट करने के लिए भी तैय समय सीमा है। तथा बीमा कंपनी को documents मांगने के लिए भी एक तैय सीमा है। आप बीमा कंपनी मे क्लेम सैटलमैट के विषय में देरी के लिए, व सही तरीके न अपनाने के लिए शिकायत दर्ज करा सकते है, बल्कि आपको जरूर शिकायत दर्ज करवानी चाहिए।
Standard बीमा पालिसी अनुबंध मे spot survey की अनिवार्यता की कोई शर्त नहीं लिखी होती है। जैसे oriental insurance company है वह अपने बीमा पालिसी अनुबंध document - commercial vehicle package policy पर spot survey की आवश्यकता को लिख देती है। वैसे बीमा पालिसी अनुबंध की शर्त 01 के अनुसार दुर्घटना की जानकारी immediately बीमा कंपनी को देनी होती है। अतः बीमा धारक ग्राहक ने जब भी बीमा क्लेम की सूचना बीमा कंपनी को दी होती है तब बीमा कंपनी को यदि लगता है कि उन्हें spot survey की कंपलसरी आवश्यकता है तो बीमा कंपनी वह spot survey को करा सकती है। दुर्घटना स्थल पर दुर्घटनाग्रस्त गाड़ी हो तो बेहतर है, नहीं है तो वापस आ सकती है और अगर वापस लाने मे मुश्किल है तब भी कोई बात नहीं गाड़ी के अलावा बाकी सब तो दुर्घटना स्थल पर मौजूद है। बीमा कंपनी spot survey करवा सकती है। लेकिन इसके न होने से, 25% क्लेम काटना यह बिलकुल भी तार्किक नहीं है।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
आपको बीमा कंपनी को लिखकर पूछना चाहिए, कि आपकी गाड़ी का अभी तक क्लेम सैटलमैट क्यों नहीं हुआ है। देरी की वजह क्या है। और अभी क्लेम सैटलमैट में कितना समय और लगेगा।
Hello sir Policy mein jitne bima rashi Bari hoti hai Jaise 380000 Total loss mein utani hi rakam milati hai kya Sar meri gadi ka accident ho gaya tha gadi total loss mein Chali gai Bima company bol rahi hai aapane gadi ki kimat jyada bharvaya hua hai aapko ham 380000 nahin ₹282000 denge hamare hisab se gadi ki kimat 282000 Ab mujhe kya Karna chahie court mein jana chahie Please sujhav dijiye Thanks
Investigation के लिए कोई तैय process नहीं है। अलबत्ता एप्रूवड सर्वेयर की साधारण बीमा के अंतर्गत investigation की जिम्मेदारी होती है। ऐसा सर्वेयर रेगूलेशन 2015- 20 मे लिखा है। अतः investigation कार्य के लिए एक एप्रूवड सर्वेयर उपयुक्त व्यक्ति होता है। एप्रूवड सर्वेयर के लिए code of conduct, duties and responsibilities तैय होती है। एप्रूवड सर्वेयर बीमा कानून के अंतर्गत एक legal entity होता है।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Sir meri gadi ka accident 30 Jul 2022 ko hua. Mujhe bina bayate meri gadi ko total loss kar diya aur online sell kar di. Mujhe bina bayate ab 1 month baad mere pass call aa rahe hai gadi sell karne ke liye. Mujhe total loss nahi karwani par koi baat hi nahi kar raha kya karo plz help
Sir mene scooty di hui h apni front se damage ho gya tha usme wrong side ae aa rhe vehicle ne achank se takkar mar di thi toh mene claim k liye di hui h workshop m 1 hafte se jyada ho gya approval ni dia surveyour ne abhi to survey kr liya h but approval nhi dia aur ab 1 hafte bad keh rhe h ki apka claim justify nhi ho rha h documents ok h mere ab kya krna chaiye sir mujhe PLEASE HELP
सर मेरी गाड़ी का accident हो गया और गाड़ी total loss में चली गयी। मैने FIR में परिवार लिखाया था। लेकिन उसमें 3 लोग परिवार रिस्तेदार है और 3 लोग दोस्त है। तो इसे कैसे handle करे ?
आपने FIR में परिवार लिखाया था, और गाड़ी में कुल 06 लोग थे। दोस्त भी पारिवारिक सदस्यों की तरह ही होते है। यदि आपने FIR मे पारिवारिक सदस्य लिखवाया है तो इससे कोई फर्क नहीं पड़ना चाहिए।
Motor insurance policy has risk coverage for the entire vehicle. Risk coverage of the vehicle insurance policy is equally applicable to each and every part of the vehicle. The insurance policy is a contract of indemnity. The engine is also a part of the vehicle.
@@jatinsingh4671 Private Car Package Policy Condition 04:- 4. The insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the Company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and """"" if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured's own risk""""".
Company se gadi nikale 2 mahine hue the gadi ka accident Ho Gaya gadi ko workshop Mein 8 mahine Ho Gaye Khade Sahi Karke Nahin de rahe Kya Karen sujhav den
Sir my Vehicle got accident in which repair cost is is 2.20 lakhs my idv of vehicle is 321000 with 0 dep , insurance company is restricted liability to 170000 , over above I have to bare they saying , my question can they do that ?
No. STANDARD FORMFOR PRIVATE CAR PACKAGE POLICY :- Policy condition 03- 3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and the liability of the company shall not exceed: (a) for total loss / constructive total loss of the vehicle - the Insured's Declared Value (IDV)of the vehicle (including accessories thereon) as specified in the Schedule less the value of the wreck. (b) for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle - actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified.
@@motorinsuranceclaimspracti4142 Sir I did not understood the above section as per your video I understand that if the repair cost exceed 75% of IDV then it can be declared total loss if it's below 75% the insurer can't refuse to repair is it right sir???
यदि accident की वजह overseating है तब तो क्लेम नहीं मिलना चाहिए। लेकिन यदि accident की वजह overseating नहीं है तो फिर तो यह claim मिलना चाहिए। यह fundamental breach का मामला नहीं होगा। ऐसे मामले मे तो एक supreme court का निर्णय भी है, जिसमे क्लेम को सर्वोच्च न्यायालय के आदेश से pay किया गया है। वैसे भी आप बीमा पालिसी या एप्रूवड सर्वेयर साहब से इस क्लेम को न मिलने का कारण, specific reason, बीमा पालिसी अनुबंध के अनुसार पूछियेगा। उनसे पूछना की बीमा पालिसी अनुबंध की किस terms and conditions के violation के तहत यह क्लेम नहीं मिलना चाहिए।
Fact:- Fundamental breach- The Law of Insurance is based upon the contract of indemnity whereby the Insurer indemnifies the insured against the loss as per the terms and conditions stipulated in the contract and insurer cannot escape its liability unless there is a fundamental breach of contract resulting in repudiation of contract and not every breach. Even if the insurance company is able to prove that there is breach of concerning policy conditions, the insurer would not be allowed to avoid its liability towards insures unless the said breach is so fundamental as to be found to have contributed to the cause of the accident. AKS.G.N.
Sir meri car new hai aur sirf 2 mahine hue h , zero dep insurance hai digit ka .abhi thoda accident ho gya to aage thoda damage ho gya . Phir gadi showroom me dedi aur jab verification k liye call aaya to galti se ghar ka nam bta dia , ab wo usi nam se driving licence mang rahe hai , ab ghar ke nam se driving licence hai nahi , ab wo approval nahi de rahe hain to kya karen , please bataye sir
आप बीमा कंपनी को email पर इसके लिए clarification दे दो। और यदि बीमा कंपनी इसके बाद भी नहीं माने तो फिर बीमा कंपनी मे इसके लिए grievance दर्ज करना। यदि बीमा कंपनी फिर भी नहीं माने तो फिर इसके लिए, बीमा लोकपाल आफिस मे शिकायत दर्ज कराना। आप अपने घरेलू व असली नाम के लिए एक affidavit, एक अपने parents का नाम के विषय मे supporting letter व एक अपने करीबी पड़ोसी का घरेलू व असली नाम के समर्थन मे letter, बीमा कंपनी को भेजना। मैन कुछ समय पहले बिलकुल इसी प्रकार का क्लेम deal किया था। यह क्लेम मे हमें बीमा लोकपाल आफिस के Award से न्याय मिल गया था, बीमा क्लेम मिल गया था। लेकिन यह क्लेम केस मे हमने गाड़ी अपने खर्चे पर शुरुआत मे ही ठीक करवा ली थी, लगभग 02-03 महीने बाद हमे बीमा क्लेम मिला था।
मैने जो अभी आपसे बताया था कि मैंने पहले आपकी इसी क्लेम की तरह एक claim को deal किया है, जो कि बीमा लोकपाल आफिस के निर्णय द्वारा बीमा धारक ग्राहक को मिला था। वह क्लेम केस में भी, बीमा कंपनी go digit ही थी।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Sir mere pass mahindra pick up he is gadi ka accident hua tha repair approval de diya mere se repair ke sb paise bharwa diye ab pymt dene ka time aaya to bol rhe he ki gadi ka permit nhi he 3000 kg se jayada he hona chaye is karan se claim reject kr rhe he plz help sir
PTI, NEW DELHI, ( AUGUST 01, 2014 18:41 IST UPDATED: AUGUST 01, 2014 18:44 IST) In a bid "" to save the common man from hassles"", Prime Minister Narendra Modi on Friday pushed for shifting to self-certification of documents and pitched for """minimum use of affidavits""". """"In the landmark initiative, all ministries and departments at the Centre and in states have been asked to make provision for self-certification of documents in place of affidavits""". The requirement of attestation by gazetted officers is sought to be replaced by self-certification by the citizen, a PMO statement said. Under the self-certification method, the original documents are required to be produced at the final stage. The Prime Minister, during his meeting with all Union Secretaries on June 4, had spoken of reforming the public service delivery system and bridging the governance deficit. “""" This measure is a start in that direction. It is expected to benefit the people immensely, as all affidavits not required by law shall eventually be done away with,”""" the statement said. In a communication addressed to all secretaries of the central government as well as Chief Secretaries of states and Administrators of Union Territories, the Department of Administrative Reforms and Public Grievances has noted that """“obtaining either an attested copy or "affidavit not only costs money to the poor citizen but also involves wastage of time of the citizens" as well as of the government officials.”""" The Department has called for a review of the existing requirement of affidavits and attestation by gazetted officers, and replacement by self-certification. "" In case of false self-certification, the person can be booked under relevant sections of the Indian Penal Code"". """"" Getting an affidavit is a ''tough task'' for the "common man" """"". "" People have to either shell out money to get affidavits from notary"" or approach a gazetted officer. Gazetted officers are often reluctant to attest documents due to lack of documents.
बीमा पालिसी अनुबंध मे ऐसे किसी affadavit को देने की शर्त नहीं होती है। अलबत्ता यदि बीमा कंपनी को क्लेम के संबंध मे कुछ जानकारी चाहिए है तो वह plain paper पर बीमा धारक ग्राहक के statement के रूप मे ले सकती है, यह statement भी उतनी ही value रखता है। यह 3rd party loss की जानकारी के लिए तो क्लेम फार्म में ही जानकारी होती है, वही पर इसको भरकर दिया जा सकता है। इसके लिए कोई no 3rd party loss जैसा कोई affadavit देने की आवश्यकता नहीं होती है। लेकिन हमारे देश मे यह बेसिरपैर की माँग बहुत सी बीमा कंपनी मे या बहुत से सर्वेयर बंधुओं द्वारा की जाती है। सच तो यह है कि यदि 3ed party loss claim होगा तो वह बीमा कंपनी की जिम्मेदारी होगी, चाहे बीमा धारक ग्राहक ने इस प्रकार का affidavit भी दिया हो। बीमा कंपनी ऐसे affidavit से 3rd part के लिए अपनी जिम्मेदारी से नहीं बच सकती है। हमारे देश के प्रधानमंत्री जी ने कहा था कि ये affidavit बनवाना, एक common आदमी के लिए wastage of time and wastage of money की प्रक्रिया है। और यह बात बिलकुल सही है।
Sir,need one suggestion . Insurance company has approved the claim and sent the related confirmation to body shop to reapir the accidental vehicle .At the time of accident airbag did not opened so I reported this matter to maruti , insurance company and body shop.Now i am not getting any proper response from maruti .on every email and tweet maruti is saying concerned person will get in touch with you.its almost 15 days passed .pls suggest what to do .Regards
I have raised the below question from maruti, insurance company and car body shop: My question is from the Maruti, GO Digit general Insurance Limited and Deep Motors . 1) I have purchased my vehicle in September 2021 and I drove it for around 6000 kilo meters only till the date of accident. My question: Is this vehicle as good as new after repair ? 2) shall this vehicle perform as good as new if I drove it on high speed on highways . 3) I need an undertaking from Maruti, GO Digit general Insurance Limited and Deep Motors that this vehicle will be as good as new vehicle on high speed. 4) Maruti, GO Digit general Insurance Limited and Deep Motors shall give me warranty that this vehicle shall be as SAFE as a new vehicle . If the above mentioned queries answer is not YES, then I request to kindly treat it as a total loss of accidental vehicle and provide me a new vehicle .
3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and the liability of the Company shall not exceed: (a) for total loss / constructive total loss of the vehicle - the Insured's Declared Value (IDV) of the vehicle (including accessories thereon) as specified in the Schedule less the value of the wreck. (b) for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle - actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified.
Insurance Policy contract wordings:- STANDARD FORM FOR CMV PACKAGE POLICY SECTION I. LOSS OF OR DAMAGE TO THE VEHICLE INSURED The Company ""will indemnify"" the insured """against loss or damage to the vehicle insured"" hereunder and / or its accessories whilst thereon vi. by accidental external means; with terms & conditions.......
Principle of indemnity:- """The object of the principle is to place the insured after a loss in the same financial position as far as possible, as he occupied immediately before the loss"""".
According to Indian Motor Tariff 2002 - GR.8. Insured,s Declared Value (IDV), The Insured,s Declared Value (IDV) of the vehicle will be deemed to be the SUM INSURED for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle. The IDV of the vehicle is to be fixed on the basis of manufacturer,s listed selling price of the brand and model as the vehicle proposed for insurance at the commencement of insurance /renewal and adjusted for depreciation (as per schedule specified below). The IDV of the side car(s) and / or accessories, if any, fitted to the vehicle but not included in the manufacturer,s listed selling price of the vehicle is also likewise to be fixed. The schedule of age-wise depreciation as shown below is applicable for the purpose of Total Loss/ Constructive Total Loss (TL/ CTL) claims only. """"""" A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and / or repair of the vehicle subject to terms and conditions of the policy exceeds 75% of the IDV"""". NOTE: IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles ( i.e. models which the manufacturers have discontinued to manufacture) is to be determined on the basis of an understanding between the insurer and the insured. For the purpose of TL/CTL claim settlement, this IDV will not change during the currency of the policy period in question. It is clearly understood that the liability of the insurer shall in no case exceed the IDV as specified in the policy schedule less the value of the wreck, in as is where is condition.
Irdai की website पर जाकर बीमा सर्वेयर बनने के विषय मे जान सकते है। आप irdai की website से सर्वेयर रेगुलेशन 2015-20 को download कर सकते है, उसमे एप्रूवड सर्वेयर के बनने बारे मे पुरा procedure दिया हुआ है।
इसके लिए आपको एप्रूवड सर्वेयर व बीमा कंपनी दोनो से protection of policy holders interest gazette notification 2017 मे General insurance claim के तैय guidelines के अनुसार लिखित में जवाब माँगना चाहिए। एप्रूवड सर्वेयर साहब व बीमा कंपनी दोनो से सर्वे रिपोर्ट कापी, interim survey report copy आदि की माँग करनी चाहिए। लेकिन यह सब माँग को लिखित मे ईमेल से करना। यदि ये आपको उचित जवाब नहीं देते है तो irdai, department of financial services आदि मे इस विषय में शिकायत करना।
Aaj rat ko kisi ne meri alto car jla di h ab kya mere ko claims milega ya nhi abi hmne insurance ko short circuit se jli hui batai h kya claim milega ya nhi Please reply
बीमा पॉलिसी मे fire, malicious act, self ignition आदि perils कवरेज होती है। आपका बीमा क्लेम admissible होगा या नहीं होगा, यह बीमा पॉलिसी की terms and conditions पर निर्भर करेगा। सच के साथ चलना महत्वपूर्ण होता है। आप एक तरफ लिख रहे है कि गाड़ी को रात मे किसी न आग लगा दी, जबकि दूसरी तरफ आपने बीमा कंपनी को short circuit के कारण आग लगना बताया है। यह मेरी समझ से परे है। मेरा मानना है कि सच व सही के साथ चलना ही बेहतर होता है।
@@ravisinghal4499 तो फिर वही statement होना चाहिए, ऐसा मेरा मानना है। statement मे बदलाव सही नहीं है। जैसे आपको पता ही नही है लेकिन आपने मुझे बताया था कि किसी ने रात मे गाड़ी मे आग लगा दी। आपने ही मुझे बताया कि आपने बीमा कंपनी को short circuit के कारण आग लगने बताया। जबकि आपके अनुसार अपको यह तो पता है कि गाड़ी मे आग लगी है, लेकिन कैसे किस वजह से लगी है, यह जानकारी नहीं है। मेरा मानना है कि आपको यही सबको बताना चाहिए। statement मे बदलाव संदेह पैदा करता है।
आपको जानना होगा कि, बीमा नियमों के सापेक्ष, आपकी बीमा पालिसी अनुबंध के सापेक्ष व बीमा नियमों के सापेक्ष, आपके साथ क्या क्या गलत हो रहा है। आपको इन गलत के लिए बीमा कंपनी व higher authorities को सही तरीके से ( लिखित में ईमेल आदि से) शिकायत करनी होगी। अपना वाजिव हक पाने के लिए प्रयास करना होगा।
बीमा कंपनी , irdai officials व संबंधित Authorities को delay in settlement के लिए लिखित में शिकायत करो। इस क्लेम केस में नियुक्त एप्रूवड सर्वेयर साहब से क्लेम एप्रूवल मे देरी की वजह लिखित मे पूछो व इसके लिए शिकायत करो।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Sir I just want to ask on thing that can a surveyor send his subordinate who don’t have any surveyor license on his behalf to inspect the accident scene and to insured to fill up the forms and ask for documents like call records Google timeline and driving license of the persons other than driver in the accident claim case.
आप बीमा कंपनी के chief grievance officer को इस विषय मे लिखित शिकायत किजिये। इसके बाद बीमा कंपनी आपको कुछ प्रतिशत काटकर क्लेम देने के लिए तैयार हो सकती है। यदि फिर भी बीमा कंपनी क्लेम देने को तैयार नहीं होती है, तो फिर आप इसके लिए बीमा लोकपाल आफिस में शिकायत दर्ज कर सकते है, वहां से आपको न्याय मिल सकता है।
@@motorinsuranceclaimspracti4142 Thank you very much sir for reply. Maine consumer forum me complaint dal di hai. Jaise apne suggest kiya waise me Chief Gravience officer ka mail id dhundne ki koshish karta hun
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
आप बीमा कंपनी से इस विषय मे पूछ सकते है। आप क्लेम सैटलमैट के लिए तैय समय सीमा को protection of policy holders interest gazette notification 2017 मे General Insurance claims के लिए तैय guidelines से जान सकते है।
आप इसके लिए बीमा कंपनी मे शिकायत कर सकते है। आप इसके लिए फिर irdai में शिकायत कर सकते है, फिर आप बीमा लोकपाल में शिकायत कर सकते है, फिर आप department of financial services, pmo, centeral government public Grievance में शिकायत कर सकते है, फिर आप उपभोक्ता फोरम मे शिकायत कर सकते है, फिर आप न्यायलय में शिकायत कर सकते है।
यह क्लेम केस के लिए proper way मे, बीमा नियमों के सापेक्ष, बीमा कंपनी व संबंधित higher authorities को शिकायत की थी। इसके बाद बहुत ही जल्दी बीमा कंपनी ने यह क्लेम settle कर दिया था।
Protection of policy holders interest gazette notification 2017,- 15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY 1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of such a communication, a general insurer shall respond immediately and give clear information to the insured on the procedures that he should follow. In cases where a surveyor has to be appointed for assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of intimation from the insured. Insurer shall communicate the details of the appointment of surveyor, """"including the role, duties and responsibilities of the surveyor to the insured by letter, email or any other electronic form immediately after the appointment of the surveyor"""". 2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the essential documents and other requirements that the claimant should submit in support of the claim""""". Where documents are available in public domain or with a public authority, the surveyor/insurer shall obtain them. 3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate survey, in any case within 48 hours of his appointment. Interim report of the physical details of the loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than 15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by the insurer to the insured/claimant, if he so desires"""". 4. Where the insured is unable to furnish all the particulars required by the surveyor or where the surveyor does not receive the full cooperation of the insured, """" the insurer or the surveyor, as the case may be, shall inform in writing to the insured under information to the insurer about the consequent delay that may result in the assessment of the claim""" . """" It shall be the duty equally of the insurer and the surveyor to follow up with the insured for pending information/documents guiding the insured with regard to submissions to be made"""". """" The insurer and/or surveyor shall not call for any information/document that is not relevant for the claim""""". 5. (i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment. """"A copy of the surveyor’s report shall be furnished by the insurer "to the insured/claimant", if he so desires"""". Notwithstanding anything mentioned herein, in case of claims made in respect of commercial and large risks the surveyor shall submit the final report to the insurer within 90 days of his appointment. However, such claims shall be settled by the insurer within 30 days of receipt of final survey report and/or the last relevant and necessary document as the case may be. (ii) Where special circumstances exist in respect of a claim either due to its special / complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may make provisional/ on account payment based on the admitted claim liability. 6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor, under intimation to the insured/claimant; to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the final survey report. Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than once in the case of a claim. 7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks from the date of receipt of communication from the insurer. 8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt of all required information/documents that are relevant and necessary for the claim, an insurer shall, with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey report and/or additional information/documents or the additional survey report, as the case may be. 9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the insurer shall give the reasons for the same in writing drawing reference to the specific terms and conditions of the policy document""". 10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and necessary document from the insured/claimant by insurer till the date of actual payment""". 19. GENERAL PRINCIPLES: 6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
आपको protection of policy holders interest gazette notification 2017 में General insurance claim guidelines को पढ़ कर समझ कर यह जान लेना है कि बीमा कंपनी आपके क्लेम मे क्या गलत कर रही है। उसके बाद उस विषय मे बीमा कंपनी के chief grievance officer को irdai officials को, dfs officials को proper way में शिकायत करनी है। यदि एप्रूवड सर्वेयर साहब सही से, निष्पक्षता से, आजादी से, सर्वेयर रेगुलेशन 2015-20 में तैय एप्रूवड सर्वेयर की duties and responsibilities, code of conduct के दायरे में, सही समय सीमा मे कार्य नहीं कर रहे है तो आप इस विषय मे भी इन्ही उपरोक्त को proper way में शिकायत कर सकते है।
You should send a proper complaint in this regard to the insurance company and the concerned authorities in writing as per the Surveyor Regulation 2015-20.
My car Total loss , declared on 9 oct, clame 433000 . But insurance company giving me 1,38000 and told me rest of money i will get from salvage buyer as company had online auctions the car with RC. What shall i do. They haven't given me anything writing
As per IRDAI Circular-CircularRef. No:IRDAI/NL/CIR/MOTOD/118/07/2019Date:26-07-2019Misuse of Total Loss Accident Vehicle Documents over Stolen VehiclesTo, ALL GENERAL INSURERS (OTHER THAN STAND-ALONE HEALTH INSURERS AND SPECIALISED INSURERS) Re: - Misuse of Total Loss Accident Vehicle Documents over Stolen Vehicles It has come to the notice of Authority that in case of Total Loss (TL) of the vehicle, salvage of the vehicle is being sold to scrap dealers without cancelling Certificate of Registration (RC) of the vehicle. 2. It has been informed by the Law Enforcement Authorities that documents pertaining to such vehicles are being misused like giving new identity to the stolen vehicles by forging engine number and chassis number of destroyed vehicles under TL claims. 3. As per Section 55 of Motor Vehicle Act 1988, (1) If a motor vehicle has been destroyed or has been rendered permanently incapable of use, the owner shall, within fourteen days or as soon as may be, report the fact to the registering authority within whose jurisdiction he has the residence or place of business where the vehicle is normally kept, as the case may be, and shall forward to the authority the certificate of registration of the vehicle. (2) The registering authority shall, if it is the original registering authority, cancel the registration and the certificate of registration, or, if it is not, shall forward the report and the certificate of registration to the original registering authority and that authority shall cancel the registration. 4. In view of the above, all insurers are advised to ensure cancellation of Certificate of Registration (RC) of the vehicle in case of total loss claim settlement. Yours faithfully,
According to Indian Motor Tariff 2002. STANDARD FORM FOR PRIVATE CAR PACKAGE POLICY :- Policy condition 03- 3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and the liability of the Company shall not exceed: (a) for total loss / constructive total loss of the vehicle - the Insured's Declared Value (IDV) of the vehicle (including accessories thereon) as specified in the Schedule less the value of the wreck. (b) for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle - actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified.
As per IRDAI Circular-Circular Ref. No:IRDAI/NL/CIR/MOTOD/118/07/2019 Date:26-07-2019 """Misuse of Total Loss Accident Vehicle Documents over Stolen Vehicles""" To, ALL GENERAL INSURERS (OTHER THAN STAND-ALONE HEALTH INSURERS AND SPECIALISED INSURERS) Re: - Misuse of Total Loss Accident Vehicle Documents over Stolen Vehicles It has come to the notice of Authority that in case of Total Loss (TL) of the vehicle, salvage of the vehicle is being sold to scrap dealers without cancelling Certificate of Registration (RC) of the vehicle. 2. It has been informed by the Law Enforcement Authorities that documents pertaining to such vehicles are being misused like giving new identity to the stolen vehicles by forging engine number and chassis number of destroyed vehicles under TL claims. 3. """ As per Section 55 of Motor Vehicle Act 1988, (1) If a motor vehicle has been destroyed or has been rendered permanently incapable of use, the owner shall, within fourteen days or as soon as may be, report the fact to the registering authority within whose jurisdiction he has the residence or place of business where the vehicle is normally kept, as the case may be, and shall forward to the authority the certificate of registration of the vehicle. (2) The registering authority shall, if it is the original registering authority, cancel the registration and the certificate of registration, or, if it is not, shall forward the report and the certificate of registration to the original registering authority and that authority shall cancel the registration. 4. In view of the above, all insurers are advised to ensure cancellation of Certificate of Registration (RC) of the vehicle in case of total loss claim settlement."""" Yours faithfully,
According to Indian Motor Tariff 2002. GR.8. Insured‟s Declared Value (IDV) The Insured‟s Declared Value (IDV) of the vehicle will be deemed to be the „SUM INSURED‟ for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle. The IDV of the vehicle is to be fixed on the basis of manufacturer‟s listed selling price of the brand and model as the vehicle proposed for insurance at the commencement of insurance /renewal and adjusted for depreciation (as per schedule specified below). The IDV of the side car(s) and / or accessories, if any, fitted to the vehicle but not included in the manufacturer‟s listed selling price of the vehicle is also likewise to be fixed. """" A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and / or repair of the vehicle subject to terms and conditions of the policy exceeds 75% of the IDV"""". NOTE: IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles ( i.e. models which the manufacturers have discontinued to manufacture) is to be determined on the basis of an understanding between the insurer and the insured. For the purpose of TL/CTL claim settlement, this IDV will not change during the currency of the policy period in question. It is clearly understood that the liability of the insurer shall in no case exceed the IDV as specified in the policy schedule """"""less the value of the wreck"""""", in „as is where is‟ condition.
मै नहीं जानता कि आप कौन है। आपका मानना किसी भी विषय पर मुझसे अलग हो सकता है। मेरा जो कुछ भी मानना है वह बीमा नियमो के अनुसार है। मुझे आपसे जानने व समझने की कोई जरूरत ही नहीं है। मै स्वयं भी एक qualified Approved Surveyor हूँ। धन्यवाद।
आपने मुझसे पहले भी मेरा फोन नंबर मांगा था। मै यहाँ You tube पर privacy के नजरिए से अपना फोन नंबर नहीं लिखता हूँ। आप मुझसे मेरी email id ashok.1224@rediffmail.com के द्वारा संपर्क कर सकते है। आप मुझे ईमेल करेंगे तो मै आपको अपनी पुरी contact details भेज दूंगा।
सर बहुत बहुत धन्यवाद आपका जो आपने हमे ये जानकारी दी। मेरी गाड़ी भी एक्सीडेंट हुई थी। सर्वेयर साहब भी mughe यही बात कह रहे है की investigetion लगा है।कोई inqari नही मेरी गाड़ी को डेढ़ महीना हो गया है । मेरी comrceal गाड़ी है किस्त मै घर से भर रहा हु।मै गरीब आदमी हु ।मेरा परिवार गाड़ी की कमाई से चलती है। मै क्या करू सर। बहुत parishan हु। प्लीज
thankyou so much sir your information is very helpful for us, Really appreciate your work🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉🎉
Mere sth bhi esa ho raha hai blood group match Nahin ho raha co-driver ka isliye bol rahe hain no claim Ghadi Koi Aur chala raha tha
Thank you very much sir for very good information and your valuable time for us so
As per Surveyor Regulation 2015-
CHAPTER IV
DUTIES AND RESPONSIBILITIES OF A SURVEYOR AND LOSS ASSESSOR
13. It shall be the duty of every Licensed Surveyor and Loss Assessor
to
investigate,
manage,
quantify,
validate and
deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or
insured, as the case may be.,
All Licensed Surveyors and Loss Assessors shall carry out the said work with
competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these Regulations.
सर बहुत बहुत धन्यवाद आपका जो आपने हमे ये जानकारी दी। मेरी गाड़ी भी एक्सीडेंट हुई थी। सर्वेयर साहब भी mughe यही बात कह रहे है की investigetion लगा है।कोई inqari नही मेरी गाड़ी को डेढ़ महीना हो गया है । मेरी comrceal गाड़ी है किस्त मै घर से भर रहा हु।मै गरीब आदमी हु ।मेरा परिवार गाड़ी की कमाई से चलती है। मै क्या करू सर। बहुत parishan हु। प्लीज
@@brijmohan7191
बीमा कंपनी को लिखित में अपनी भाषा मे email पर शिकायत किजिए।
हद से ज्यादा भ्रष्टाचार:-
आजकल के समय मे हमारे देश में मोटर बीमा पैकेज बीमा पालिसी के अंतर्गत मोटर od claim विषय में CTL/TL claim case में, सैटलमैट करने के तरीके मे बहुत बहुत अधिक भ्रष्टाचार चल रहा है। यह भ्रष्टाचार बहुत ही खुलेआम हो रहा है। यहां तक कि यदि इस विषय मे बीमा धारक ग्राहक की और से बीमा कंपनी व बीमा नियामक- IRDAI को शिकायत की जाती है तो भी अधिकांश मामलों में कुछ हासिल नहीं हो पाता है। कोई सुनवाई ही नहीं होती है।
मोटर पैकेज बीमा पालिसी, जैसे निजी कार पैकेज बीमा पालिसी, मे एक condition no. 03 होती है।
बीमा पालिसी की condition 03 मे क्लेम सैटलमैट करने के लिए 02 तरीके दिये होते है।
एक तो CTL/TL claim case
व
दुसरा अन्य सभी- partial loss claim.
बीमा पालिसी अनुबंध की शर्त 03 मे लिखा होता है कि बीमा कंपनी के पास क्लेम सैटलमैट भुगतान करने के लिए मुख्यतः 03 विकल्प होते है।
A,
repair reinstate.
वाहन की मरम्मत करके बहाल करने का।
B,
Replacement of vehicle or parts accessories...
वाहन को replacement करके, या पार्टस accessories को replacement करके।
( Note:- यहाँ पर पुराने वाहन या पुराने पार्टस के लिए नहीं लिखा हुआ है। यह शर्त नये वाहन या नये parts के लिए होती है, अलबत्ता यदि बीमा धारक ग्राहक की मर्जी है तो वह इसे पुरानी गाड़ी के बदलाव या पुराने पार्टस के बदलाव के साथ भी इस शर्त को अपना सकता है, लेकिन इसके अंतर्गत, पुराने के बदलाव लिए, बीमा धारक ग्राहक पर दबाव नहीं डाला जा सकता है।)
C,
pay the cash amount of loss or damage.
बीमा पालिसी अनुबंध की शर्त 03 में, मोटर बीमा OD claim के लिए बीमा कंपनी की liability को तैय करने का नियम दिया होता है। इसमे liability तैय करने के लिए 02 तरीके दिये होते है।
a,
जो क्लेम केस total loss या constructive total loss के दायरे मे आते है। constructive total loss की परिभाषा, G.R. 08 के अनुसार होती है।
उनमें बीमा कंपनी की अधिकतम liability, गाड़ी की IDV - less wreck value, terms and conditions के तहत होती है।
b,
CTL/TL claim case के अलावा सभी केस partial loss क्लेम केस होते है।
इसमे बीमा कंपनी की liability, actual and reasonable costs of repair or replacement
subject to terms and conditions of policy होती है।
Findings:-
1, यहाँ पर total loss व constructive total loss सैटलमैट करने के लिए
IDV - Wreck value को लिखा हुआ है।
आप यदि जानना चाहे तो dictionary मे देख सकते है कि wreck का मतलब क्या होता है। wreck का मतलब कबाड़ ही होता है। Wreck value का मतलब बिलकुल भी, गाड़ी के रूप मे transfer करके बेचने से प्राप्त value से नहीं होता है।
2, यहाँ सिर्फ दो तरीके के क्लेम सैटलमैट तरीके दिये है।
CTL/TL claim case
Partial loss claim case.
3,
Total loss claim व Constructive total loss सैटलमैट करने के लिए तरीके मे कोई भी फर्क नहीं दिया हुआ है। दोनों को सैटलमैट करने का तरीका एक ही है।
सार :-
कुल मिलाकर मेरा कहना यह है कि निजी क्षेत्र की अधिकांश साधारण बीमा कंपनी, constructive total loss, क्लेम केस को गलत तरीके से, गाड़ी साल्वेज को एक गाड़ी के रूप मे बिकवाकर, गलत तरीके से क्लेम को सैटलमैट कर रही है।
और सबसे महत्वपूर्ण बात यह है कि यह कार्य इतनी धूर्तता के साथ करती है कि इस तरीके के क्लेम सैटलमैट के लिए, बीमा धारक ग्राहक को लिखित मे क्लेम सैटलमैट आफर लैटर जिसमे अपनी जिम्मेदारी सहित क्लेम सैटलमैट तरीके को लिखकर दे, लिखित मे देकर नहीं करती है।
उल्टा बीमा धारक ग्राहक को एक consent format देकर, जबरदस्ती धूर्तता के साथ, उससे उसकी मर्जी पसंद के अनुसार यह विकल्प की चाहत को लिखवाकर ले लेती है। ताकि यदि कभी भविष्य में कोई कानूनी मामला आये तो उससे बीमा कंपनी साफ साफ बच जाय, बीमा कंपनी कह सके कि हमने तो यह तरीका बीमा धारक ग्राहक के कहने पर उसकी चाहत पसंद के अनुसार किया है। इस प्रकार के गलत कार्य मे अक्सर कुछ चुनिंदा एप्रूवड सर्वेयर भी बीमा कंपनी का साथ देते है, जो कि बहुत दुर्भाग्यपूर्ण है।
इस प्रकार की गाड़ी के तौर पर बिकी salvage का अक्सर चोरी की गाड़ी मे इस्तेमाल होता है। आप अक्सर अखबार मे इस तरीके की खबरों को पढ़ सकते है।
वैसे irdai ने भी इसके लिए सभी साधारण बीमा कंपनी को advisory जारी की हुई है कि सभी बीमा कंपनी total loss claim मे गाड़ी की rc को निरस्त करके क्लेम सैटलमैट करे।
लेकिन यहाँ अधिकांश निजी क्षेत्र की साधारण बीमा कंपनी पर इसका कोई फर्क नहीं पड़ रहा है। इन अधिकांश बीमा कंपनी के अधिकारी कर्मचारी ने constructive total loss के लिए अपनी अपनी पसंद मर्जी के अनुसार परिभाषा बना रखी है व उसे ही अमल मे ला रहे। यह सब कुछ बहुत ही खुलेआम चल रहा है।
वास्तव मे यह बहुत ज्यादा निराशाजनक है।
STANDARD FORM FOR PRIVATE CAR PACKAGE POLICY :-
Policy condition 03-
3. The Company may at its own option
repair reinstate or
replace the vehicle or part thereof and/or its accessories or
may pay in cash the amount of the loss or damage
and """the liability of the Company shall not exceed""":
(a) """"for total loss / constructive total loss of the vehicle"""" -
the Insured's Declared Value (IDV) of the vehicle (including accessories thereon) as specified in the Schedule ""less the value of the wreck"".
(b) ""for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle""" -
actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified.
अशोक कुमार सिंह,
ग्रेटर नोएडा, उत्तर प्रदेश।
20.11.2021.
Bhot achi knowledge 👍👍👍
Mera 1 claim chal rha hai or choal company mostly claims ko bevajh reject kr deti hai agar mera b claim reject kr de to me kya kru
सही उचित तरीके से इस विषय मे बीमा कंपनी, irdai officials व संबंधित उच्च Authorities को शिकायत कीजिये।
What is the role of an investigator in an insurance company?
An insurance investigator is an individual who inspects and researches an insurance claim to ensure no fraud is occurring. They gather information from the insurance adjuster , law enforcement, claimant and witnesses in order to develop a better understanding of the case and decide whether the claim is valid
As per Surveyor Regulation 2015..
CHAPTER IV
DUTIES AND RESPONSIBILITIES OF A SURVEYOR AND LOSS ASSESSOR
13. It shall be the duty of every Licensed Surveyor and Loss Assessor
to
""""investigate""",
manage,
quantify,
validate and
deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or
insured, as the case may be., All Licensed Surveyors and Loss Assessors shall carry out the said work with
competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these
Regulations.
Insurance karwao mt bhai loug.... Bhut tang krty hai ye loug
Thank you sir very informative 👍
THANK YOU SO MUCH SIR
82. For section 64UM of the Insurance Act, the following section shall be substituted, namely:-
‘64UM.
(1) Save as otherwise provided in this section, no person shall act as a surveyor or loss assessor in respect of general insurance business after the expiry of a period of one year from the commencement of the Insurance Laws (Amendment) Act, 2015, unless he-
(a) possesses such academic qualifications as may be specified by the regulations made under this Act; and
(b) is a member of a professional body of surveyors and loss assessors, namely, the Indian Institute of Insurance Surveyors and Loss Assessors: Provided that in the case of a firm or company, all the partners or directors or other persons, who may be called upon to make a survey or assess a loss reported, as the case may be, shall fulfil the requirements of clauses (a) and (b).
(2) Every surveyor and loss assessor shall comply with the code of conduct in respect of his duties, responsibilities and other professional requirements, as may be specified by the regulations made under the Act.
(3) Notwithstanding anything contained in the foregoing provisions, a class or class of persons acting as a licensed surveyor or loss assessor prior to the commencement of the Insurance Laws (Amendment) Act, 2015 shall continue to act as such for such period as may be specified by the regulations made under this Act: Provided that the surveyor or loss assessor shall, within the period as may be notified by the Authority, satisfy the requirements of clause (a) and clause (b) of subsection (1), failing which, the surveyor or loss assessor shall be automatically disqualified to act as a surveyor or loss assessor.
(4) No claim in respect of a loss which has occurred in India and requiring to be paid or settled in India equal to or exceeding an amount specified in the regulations by the Authority in value on any policy of insurance, arising or intimated to an insurer at any time after the expiry of a period of one year from the commencement of the Insurance Laws (Amendment) Act, 2015, shall, unless otherwise directed by the Authority, be admitted for payment or settled by the insurer unless he has obtained a report, on the loss that has occurred, from a person who holds a licence issued under this section to act as a surveyor or loss assessor (hereafter referred to as "approved surveyor or loss assessor"):
Provided that nothing in this sub-section shall be deemed to take away or abridge the right of the insurer to pay or settle any claim at any amount different from the amount assessed by the approved surveyor or loss assessor.
Total loss is pure harassment. Showroom will charge you on daily basis. And insurance settlement may take 3-4 months including RC cancellation. RC cancellation is much tough process. It is really harrasment by insurance company.
car m air bag damage h aur agar car ka claim reject ho jaye, to grievance submit krne k baad. Car ko service centre pr rehne de ya wapas le k aa jaye ????
Service centre pr charges lagege insurance claim reject hone k baad aur grievance ka reply aane m time lagega
kuch bataye kya karu, car running condition m h
Sir I have a question.after my car accident surveyor gave work approval for repair of car.but after giving work approval I got a call from insurance company that there will be a investigation.investigator came and did the investigation.report not came.
Now, my question is that after giving approval by surveyor via mail why investigation is happening.
Is there a chance to reject my claim by insurance company?
Surveyor mailed body shop to start the repair work.
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
यदि कोई बीमा पालिसी अनुबंध का उल्लंघन होगा तो बीमा कंपनी क्लेम देने से मना कर सकती है। बीमा कंपनी मे एक शर्त right to recovery भी होता है यदि बीमा कंपनी ने किसी वजह से आपको कोई बीमा क्लेम गलती से दे दिया और बाद मे बीमा कंपनी को यह गलती का पता चलता है, तब बीमा कंपनी right to recovery के अधिकार से पहले हुए गलत भुगतान को वापस मांग सकती है, यदि कोई न दे तो इसके लिए court में जा सकती है।
वैसे किसी साधारण बीमा क्लेम मे एप्रूवड सर्वेयर की सर्वे रिपोर्ट बहुत अधिक मायने रखती है। एप्रूवड सर्वेयर का काम investigation का भी होता है।
लेकिन सामान्यतः बीमा कंपनी, जिन्हें Investigator के तौर पर नियुक्त करती है, अधिकांश ये सिर्फ पेपर्स, statements एकत्र करके बीमा कंपनी तक पहुँचाने वाले होते है। वैसे बीमा कानून मे अलग से Investigator कोई legal entity नहीं होता है। इसलिए इनके लिए कोई duties and responsibilities:-, code of conduct तैय ही नहीं है। यदा कदा ये बहुत से बीमा धारक ग्राहक के क्लेम को delay करने के लिए या unnecessary harrassment करने के लिए इस्तेमाल किये जाते है।
एक तरीके से इन्हें आप बीमा कंपनी का हिस्सा ही मान सकते है।
लेकिन protection of policy holders interest gazette notification 2017, मे बीमा नियामक ने General insurance claims के लिए guidelines तैय की हुई है। आप उसे पढ़ कर अपनी बीमा कंपनी से सवाल पूछ सकते है।
Sir same story mere sath ho raha hai aaj 20 din ho gay claim approve nahi hua …reliance general insurance se policy le thi
Glucose pi kr video bnao... thoda energy rahegi
साहब, सलाह के लिए बहुत-बहुत धन्यवाद।
3 month ho gay hai ab sir keay kray
आप बीमा कंपनी के officials व Chief Grievance officer को ईमेल करके इस विषय मे शिकायत कीजिये। आप हिंदी English या जो भाषा भी आपको आती है, उस भाषा मे शिकायत कर सकते है। आप को पूछना है कि इतना लंबा समय बीत गया है आपने अभी तक यह क्लेम क्यों नही settle किया है। आप लिखना कि यह side मे बैठे व्यक्ति का खुन का blood group नहीं मिल रहा है जैसा बीमा कंपनी आपको बता रही है, ऐसा क्यों है यह आप नहीं जानते है कि ऐसा क्यों है। आप सिर्फ इतना जानते है कि यह दुर्घटना हुई थी। यह व्यक्ति गाड़ी चला रहा था, और गाड़ी मे ये व्यक्ति दुर्घटना के समय मौजूद थे।
आप बिलकुल सच व सही दुर्घटना का कारण, मतलब विस्तार से दुर्घटना होने को लिखकर भी भेजना। आप लिखना की आप बीमा कंपनी से इस क्लेम विषय में संतुष्ट नहीं है। आप इस क्लेम केस की सर्वे रिपोर्ट कापी बीमा कंपनी व एप्रूवड सर्वेयर दोनों से लिखित मे मांगना।
यह शिकायत को मै आपको कुछ email I'd साझा कर रहा हूँ,उन्हें भी बीमा कंपनी के साथ साथ रखना। हर अपनी शिकायत का जबाब लिखित में मांगना।
अगर बीमा कंपनी क्लेम नो क्लेम करने का मन बना रही है तो यह पूछना की बीमा पालिसी अनुबंध कि किस specific terms and conditions के तहत no claim करने के बारे मे सोच रही है।
बीमा कंपनी को लिखना की क्लेम सैटलमैट का समय, protection of policy holders interest gazette notification 2017 मे अनुसार काफी कम होना चाहिए था, लेकिन बीमा कंपनी उन guidelines का पालन नहीं कर रही है ऐसा क्यों। और जो भी आपको शिकायत है points मे 01,02, 03 आदि करके लिखना।
उम्मीद करता हूँ कि आपको परिणाम मिल जाना चाहिए।
pankajk.tewari@irdai.gov.in
tsnaik@irdai.gov.in
tagged@irdai.gov.in
sobo3-dfs@nic.in
sg@gicouncil.in
chairman@irdai.gov.in
nimisha@irdai.gov.in
suresh@irdai.gov.in
kgplramadevi@irdai.gov.in
prabhat@irdai.gov.in
raghvanb@irdai.gov.in
AKS.G.N.
29.09.2021.
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
25/11/2021 को हुंडई शोरूम से गाड़ी ली थी और 25 /11/2021 को ही RTO और इंसोरेंस के रूपये वही शोरूम में डिपॉजिट कर दिए थे। लेकिन 29/11/2021 को गाड़ी का रजिट्रेशन किया गया था और 27 /11/2021गाड़ी accidents हो गई। अब इंसोरेंस कम्पनी ने नो क्लेम कर दिया है ।अब मुझे क्या करना चाहिए। कृपया उचित सलाह दे ।🙏🙏
Pls make a deep analysis video on IMT23
If Failed to produce Medical Document
To investigator Is valid Reason to reject Claim No Third Party Loss Happen No FIR Done.
Sir you're doing a good job
Same with my story
Accident claim ka amount Insurance company ko ritrn ho skta h ky
हमारी गाड़ी 17 को एक्सीडेंट हुयी थी पर हम उसे वर्कशॉप मे 25 को ले गये और एजेंसी के वर्कशॉप सुपरवाइजर नें बोला की आप 20-21 का लिखवाओ नहीं तो ज्यादा पुराना केस बताकर क्लेम रिजेक्ट हो जायेगा, इसीलिए हमने 21 लिख दिया, जबकि मै 21 का ड्यूटी मे था, अब कैसे बात बने please help me sir
Bhai hua kya aapka claim
hello sir,
sir my issue is, i met an accident on 6th feb 2022 and intimation to insurance company was done on 15th feb 2022, at that time estimate was made more than 75% of the IDV value and the surveyor told me that car will go in total loss and said it will take around one month, but not after 2 months surveyor is saying that we will repair the car and total loss will not be there. but now i have booked another car.
what should o do now ?
As per IRDAI book:-
(2). What is the need to engage an Insurance Surveyor ?
"""""" The need for the engagement of a surveyor is for assessing the loss/damage suffered without any bias or prejudice and by a ""professional/expert"" in the field"""" .
(3). """ If the surveyors are appointed by the insurance company, do they favour insurance companies"""?
""" This is a false notion that surveyors are the representatives of insurance companies and so they favour insurers""".
A surveyor and loss assessor shall act impartially and maintain confidentiality, neutrality without jeopardizing the liability of the insurer and the claim of the insured.
(4). Is the loss amount assessed by surveyor binding on insurer/s?
No. The insurers are not bound by the loss amount assessed by the surveyor. The insurer has the right to pay or settle any claim at any amount different from the amount assessed by the appointed surveyor.
As per Surveyor Regulations 2015-20.
CHAPTER IV
DUTIES AND RESPONSIBILITIES OF A SURVEYOR AND LOSS ASSESSOR
13. It shall be the duty of every Licensed Surveyor and Loss Assessor to investigate, manage, quantify, validate and deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or insured, as the case may be., All Licensed Surveyors and Loss Assessors shall carry out the said work with competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these Regulations.
(1) The following, shall, inter alia, be the duties and responsibilities of a Surveyor and Loss Assessor:-
(c) maintaining confidentiality and neutrality without jeopardising the liability of the insurer and claim of the insured;
(i) Reg 20-(i)
Commenting on the admissibility of the claim and assessing the liability of the insurer as per the policy terms and conditions.
(m) satisfying queries of the insured/insurer and of persons connected thereto in respect of the claim/loss;
(o) giving reasons for repudiation of claim, in case the claim is not covered by policy terms and conditions;
(2) A surveyor or loss assessor whether appointed by insurer or insured, shall submit his report to the insurer as expeditiously as possible, but not later than 30 days of his appointment, with a copy of the report to the insured giving his comments on the insured’s consent or otherwise on the assessment of loss. Where, in special circumstances of the case, either due to its special and complicated nature, the surveyor shall under intimation to the insured, seek an extension, in any case not exceeding six months from the insurer for submission of his report.
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Rule:-
General Regulations 08 as per Indian Motor Tariff:-
The Insured‟s Declared Value (IDV) of the vehicle will be deemed to be the „SUM INSURED‟ for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle.
A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and / or repair """of the vehicle"""" subject to terms and conditions of the policy exceeds 75% of the IDV.
बीमा कानून के अंतर्गत सर्वेयर रेगुलेशन 2015-20 के अनुसार, मोटर OD claim में, तैय प्रकार के 50 हजार से ज्यादा के बीमा क्लेम केस में एक एप्रूवड सर्वेयर को नियुक्त करना अनिवार्य आवश्यक होता है।
एप्रूवड सर्वेयर, सर्वेयर रेगुलेशन 2015-20 में तैय नियमों का पालन करते हुए निष्पक्षता व संबंधित बीमा विशेषज्ञता के साथ दुर्घटना क्लेम गाड़ी का सर्वे निरिक्षण करता है, व independently नुकसान आकलन व अनुशंसा करता है। एप्रूवड सर्वेयर के नुकसान आकलन व अनुशंसा कार्य मे बीमा कंपनी का कोई हस्तक्षेप नहीं होता है। एक एप्रूवड सर्वेयर क्लेम सैटलमैट विषय पर निर्णय नहीं लेता है वह सिर्फ नुकसान आकलन व अनुशंसा कर सकता है।
लेकिन अधिकांशतः हमारे देश मे एप्रूवड सर्वेयर, बजाय निष्पक्षता व संबंधित बीमा विशेषज्ञता के, बीमा कंपनी की मर्जी पसंद दिशा निर्देश आदेश के अनुसार नुकसान आकलन व अनुशंसा करते है।
मोटर बीमा पालिसी अनुबंध के अनुसार कोई भी गाड़ी CTL/TL claim तब होती है, जब वाहन का Aggregate repair cost वाहन की IDV के 75% से ज्यादा हो।
बहुत से लोग इसे भी गलत तरीके से बजाय वाहन के Aggregate repair cost के 75% of IDV से अधिक होने की जगह बीमा कंपनी की Net liability on repair basis के 75% of IDV से अधिक होने को CTL/TL claim case का आधार मानते है।
वैसे जुबानी बातो का कोई आधार नहीं होता है। आप बीमा कंपनी से interim survey report copy की मांग कर सकते है। protection of policy holders interest gazette notification 2017 के अनुसार यह 15 दिनों के अंदर अंदर बीमा कंपनी को बीमा धारक ग्राहक के मांगने पर देनी होती है।
Same problem approval nahi de rahe hai sir kya karo
Sir meri gadi ko 2 month ho gye workshop pe company na to total loss kr rhi h na hi repair ke liye bola h iski complain kha kr skte h sir
जी आपको बीमा कंपनी के grievance officer को लिखित शिकायत करनी चाहिए।
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
I will given every ans of your questions
मेरा इस विषय मे बहुत ही स्पष्ट मानना है। हो सकता है आपका मानना मुझसे भिन्न हो। यह हो सकता है। मेरा इस विषय में कोई सवाल पूछा ही नहीं है। मैंने यहाँ इस video मे अपनी बातों को रखा है।
जिस बीमा क्लेम का मै यहाँ उदाहरण दे रहा था, जब बीमा कंपनी व एप्रूवड सर्वेयर साहब को इस विषय मे मेरी इन्ही opinion के अनुसार ईमेल की गयी। तो एप्रूवड सर्वेयर साहब व बीमा कंपनी दोनो ने बीमा धारक ग्राहक को सर्वे रिपोर्ट कापी दी। बीमा कंपनी ने claim settlement offer letter दिया व बीमा कंपनी ने बीमा धारक ग्राहक को पुरा पुरा क्लेम दिया। और यह सब भी 03- 04 दिनों के अंदर मे हुआ।
ईमेल करने के बाद बीमा कंपनी की तरफ से बीमा कंपनी के वरिष्ठ अधिकारीगण व एप्रूवड सर्वेयर साहब के फोन भी बीमा धारक ग्राहक को आने लगे थे। जबकि पहले ये कोई बात नहीं करते थे।
जीवन मे विभिन्न लोगो का एक ही विषय पर मानना भिन्न भिन्न हो सकता है, इस विषय में explanations अलग अलग हो सकती है। आपका जो कुछ भी मानना है आपको जो कुछ भी सही लगता है, आप उस पर कायम रहिये। आप मेरे इस video message की बातो को ignore कर दीजिये। इसी प्रकार मेरा जो मानना है मैंने उसी के अनुसार यह video message बनाया है।
आपने मुझे जबाब लिखा इसके लिए आपका बहुत-बहुत धन्यवाद।
Sir, my scooter was stolen on 8th April, 2022 and now the surveyor told me i should have received a mail from Insurance Company. I told him I didn't receive any so he asked me to call the customer care. Then they gave me Claim Department number, I called them he said they have received the report from Surveyor and they'll review the report and it'll take 3-4 months.
So what should I do now ?
Please tell🙏
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
50% approval kiya tha Mera badh mein rejected kr diya gya
मै सही से समझ नहीं पाया हूँ।
Insurance company says claim is closed because court's A summary report was not provided ... After court give A summary report is submitted that report to insurance company but they are saying your claim is closed they are not receiving calls it's very depressing.... What should I do ?
I am sharing one irdai circular in this regard,
Ref. No:IRDA/NL/CIR/MISC/149/06/2017
Date:28-06-2017Delay in Claim Intimation/Documents Submission.
The Authority, vide circular no.IRDA/HLTH/MISC/CIR/216/09/2011 dated 20.09.2011, issued guidelines as to how to deal with delayed intimation of claims and """delayed submission of documents""" by the claimants.
Since, some insurance companies were not adhering to the provisions of the circular, the Authority further issued directions under section 34(1) of the Insurance Act, 1938, vide no.IRDA/NL/MISC/CIR/214/10/2016 dated 28.10.2016 clarifying that the circular dated 20.09.2011 is binding on the insurers.
Recently, in a legal case the Hon’ble High Court, while passing the order made several adverse comments against the Insurance Companies’ non-compliance of the Authority’s direction and ordered the Authority to take appropriate remedial measures.
In view of the above, you are hereby advised to ensure compliance with the said circulars scrupulously.
(P.J.Joseph)
Member (Non-Life)
आप बीमा कंपनी को इस उपरोक्त irdai circular के साथ बीमा क्लेम को reopen करने के लिए व क्लेम देने के लिए ईमेल कर दीजिये।
वैसे भी यह court की report को जारी करना आपके अधिकार क्षेत्र मे नहीं था।
Sir meri gadi total loss me gayi oct 20 ko and driver ka death bhi hua and sare formalities ho gyi even meko offer letter bhi aaya but jiss time pe paise transfer krni thi uss time driver ke brother ne company ko mail kiya ki uske bhai ne gadi drive ni ki. Ab iss baat ko 3 month ho gye maine police ki final report bhi submit kr di hai. Uske baad bhi claim settle nahi ho raha. even investigation 3 month se chal raha. Please help me mai kya karu
Google Timeline Location moment is valid Evidence in Any way
Investigator Called Me For Blood Group Report Of Passenger
Is it legal
Sir Mera car accident hua 10th sep ko Maine show room gaadi dediya magar insurance vaale claim nahi kar rahe he aur zung lagne ki baje se kehrahe ki purani accident hai hum claim nahi karte
आप स्वयं बीमा कंपनी को सीधे तौर पर लिखित मे डाक से, visit करके, ईमेल से, बीमा क्लेम की सूचना दे सकते है।
Hello Sir, my claim was put into investigation wherein I had provided all photos ,videos of accident spot where in I am standing in injured condition with the car. But still it has gone for investigation. And Maruti Nexa held my loaner car request saying that as per policy the can not provide the loaner car until they recieve the final approval after investigation. I m feeling mentally harrassed. Please help..
Kya apka claim promblem solve hua brother??
My car is sitting in the showroom since 15 days, but surveyor investigation is being delayed, insurance company is not cooperating; what Should I do
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Firstly you should ask all these things in writing from insurance company.
@@motorinsuranceclaimspracti4142 the surveyor has done the survey successfully, and company estimate is also finalised, further insurance head asked for investigation, and that investigation is being delayed from 1 week
Is there any time limit for investigation?
SAME 😖
Sir muje aapse thodi baat karni hai insurance claim ke bare main..meri new car total loss ho gyi hai ..iss bare Maine kuch jankari leni hai
ashok.1224@rediffmail.com
आप मेरी ईमेल I'd पर अपनी contact details भेज देना।
@@motorinsuranceclaimspracti4142 mail send .please revert me
My car was stolen and 90 day time is up but on app claim status it's showing inspection pending
You should ask about the claim status through writing email to insurance company.
Dear Sir
My car was stolen on 3rd of Feb 2022. My car was only 11 months old and I have valid insurance which will expire on 08 March 2022.
So my question is that the car was registered on my wife's name and FIR is lodged by my younger brother. So could you please confirm if this will create an issue while settling the claim?
Secondly I don't have PUC of concern vehicle, so please suggest me if this will be a issue for settlement?
It should not be issue. Vehicle PUC is not a required document for insurance claim.
@@motorinsuranceclaimspracti4142 Thank you so much sir
Puneet ji did you get your claim because my bike is also stolen and i don't have puc
Meri gaadi ka accident hua tha march ko usme driver ki death bhi ho gyi thi. Car bhi total loss mei hai. Abh tak 6 month ho gye hai iska investigation hui hai or sare documents bhi laga diye hai file mei but process insurance office mei hi latka hua hai. Manager roz naye naye kaam bta deta hai ye leke aao wo leke aao. Yr pareshan karke rakha hai. Abhi tak claim ka kuch pta nhi chal raha
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
बीमा क्लेम सैटलमैट के विषय मे बीमा नियामक ने उपरोक्त प्रक्रिया को तैय किया हुआ है। क्लेम सैटलमैट करने के लिए भी तैय समय सीमा है। तथा बीमा कंपनी को documents मांगने के लिए भी एक तैय सीमा है।
आप बीमा कंपनी मे क्लेम सैटलमैट के विषय में देरी के लिए, व सही तरीके न अपनाने के लिए शिकायत दर्ज करा सकते है, बल्कि आपको जरूर शिकायत दर्ज करवानी चाहिए।
Mera bhi 9 month ho gya hai gadi total loss hai financer alag ghusa hua hai claim pass ho chuka but paise abhi nahi mile
only commercial vehicle ka spot survey nhi kiya tho 25 % minus kiya jata hai , wo privat mai bhi hota hai kya minus
Standard बीमा पालिसी अनुबंध मे spot survey की अनिवार्यता की कोई शर्त नहीं लिखी होती है।
जैसे oriental insurance company है वह अपने बीमा पालिसी अनुबंध document - commercial vehicle package policy पर spot survey की आवश्यकता को लिख देती है।
वैसे बीमा पालिसी अनुबंध की शर्त 01 के अनुसार दुर्घटना की जानकारी immediately बीमा कंपनी को देनी होती है।
अतः बीमा धारक ग्राहक ने जब भी बीमा क्लेम की सूचना बीमा कंपनी को दी होती है तब बीमा कंपनी को यदि लगता है कि उन्हें spot survey की कंपलसरी आवश्यकता है तो बीमा कंपनी वह spot survey को करा सकती है।
दुर्घटना स्थल पर दुर्घटनाग्रस्त गाड़ी हो तो बेहतर है, नहीं है तो वापस आ सकती है और अगर वापस लाने मे मुश्किल है तब भी कोई बात नहीं गाड़ी के अलावा बाकी सब तो दुर्घटना स्थल पर मौजूद है। बीमा कंपनी spot survey करवा सकती है।
लेकिन इसके न होने से, 25% क्लेम काटना यह बिलकुल भी तार्किक नहीं है।
Sir muje 2 month ho gye abi tak claim statement nai hua please help me
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
आपको बीमा कंपनी को लिखकर पूछना चाहिए, कि आपकी गाड़ी का अभी तक क्लेम सैटलमैट क्यों नहीं हुआ है। देरी की वजह क्या है। और अभी क्लेम सैटलमैट में कितना समय और लगेगा।
Hello sir
Policy mein jitne bima rashi Bari hoti hai Jaise 380000
Total loss mein utani hi rakam milati hai kya
Sar meri gadi ka accident ho gaya tha gadi total loss mein Chali gai Bima company bol rahi hai aapane gadi ki kimat jyada bharvaya hua hai aapko ham 380000 nahin ₹282000 denge hamare hisab se gadi ki kimat 282000
Ab mujhe kya Karna chahie court mein jana chahie
Please sujhav dijiye
Thanks
अगर एक बार क्लेम रिजेक्ट हो गया तो क्या उसी केस को दुबारा क्लेम कर सकते है, अगर हा तो कितने दिन बाद और यदि नहीं तो नया केस कब क्लेम कर सकते है
ऐसा नहीं होता है।
Sir mera b same h Tata AIG se h mera
Sir od motor claim ka investigation ka process detail m bataye
Investigation के लिए कोई तैय process नहीं है। अलबत्ता एप्रूवड सर्वेयर की साधारण बीमा के अंतर्गत investigation की जिम्मेदारी होती है। ऐसा सर्वेयर रेगूलेशन 2015- 20 मे लिखा है। अतः investigation कार्य के लिए एक एप्रूवड सर्वेयर उपयुक्त व्यक्ति होता है। एप्रूवड सर्वेयर के लिए code of conduct, duties and responsibilities तैय होती है। एप्रूवड सर्वेयर बीमा कानून के अंतर्गत एक legal entity होता है।
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Sir meri gadi ka accident 30 Jul 2022 ko hua. Mujhe bina bayate meri gadi ko total loss kar diya aur online sell kar di. Mujhe bina bayate ab 1 month baad mere pass call aa rahe hai gadi sell karne ke liye. Mujhe total loss nahi karwani par koi baat hi nahi kar raha kya karo plz help
ashok.1224@rediffmail.com
Sir agar insurance company faltu k excuse dekar claim reject kr de to kya krna chhaiye pls reply
Sir mere sath bhi yahi hua hai
Please cntct kijie mujhe jankari chahie
Ashok.1224@rediffmail.com
Sir mene scooty di hui h apni front se damage ho gya tha usme wrong side ae aa rhe vehicle ne achank se takkar mar di thi toh mene claim k liye di hui h workshop m 1 hafte se jyada ho gya approval ni dia surveyour ne abhi to survey kr liya h but approval nhi dia aur ab 1 hafte bad keh rhe h ki apka claim justify nhi ho rha h documents ok h mere ab kya krna chaiye sir mujhe PLEASE HELP
सबसे पहले बीमा कंपनी मे ईमेल से यह सब जानकारी लिखकर शिकायत दर्ज करनी चाहिए।
सर मेरी गाड़ी का accident हो गया और गाड़ी total loss में चली गयी। मैने FIR में परिवार लिखाया था। लेकिन उसमें 3 लोग परिवार रिस्तेदार है और 3 लोग दोस्त है।
तो इसे कैसे handle करे ?
सच्चाई के साथ चलो।
आपने FIR में परिवार लिखाया था, और गाड़ी में कुल 06 लोग थे। दोस्त भी पारिवारिक सदस्यों की तरह ही होते है। यदि आपने FIR मे पारिवारिक सदस्य लिखवाया है तो इससे कोई फर्क नहीं पड़ना चाहिए।
Sir I have zero dep insurance for my car my car had the accident the insurance company saus they won't cover the engine
Motor insurance policy has risk coverage for the entire vehicle. Risk coverage of the vehicle insurance policy is equally applicable to each and every part of the vehicle. The insurance policy is a contract of indemnity. The engine is also a part of the vehicle.
@@motorinsuranceclaimspracti4142 sir they are saying it won't be covered because you have drove the vehicle after accident that caused engine failure
@@motorinsuranceclaimspracti4142 they are only covering the body damage
@@jatinsingh4671
Private Car Package Policy Condition 04:-
4. The insured shall take all reasonable steps to safeguard the vehicle from loss or
damage and to maintain it in efficient condition and the Company shall have at all
times free and full access to examine the vehicle or any part thereof or any driver or
employee of the insured. In the event of any accident or breakdown, the vehicle shall
not be left unattended without proper precautions being taken to prevent further damage or loss
and
""""" if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured's own risk""""".
@@motorinsuranceclaimspracti4142 thank you sir insurance company is Royal Sundaram
Company se gadi nikale 2 mahine hue the gadi ka accident Ho Gaya gadi ko workshop Mein 8 mahine Ho Gaye Khade Sahi Karke Nahin de rahe Kya Karen sujhav den
case kr de bhai insurance company prr
Sir my Vehicle got accident in which repair cost is is 2.20 lakhs my idv of vehicle is 321000 with 0 dep , insurance company is restricted liability to 170000 , over above I have to bare they saying , my question can they do that ?
No.
STANDARD FORMFOR PRIVATE CAR PACKAGE POLICY :-
Policy condition 03-
3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and the liability of the company shall not exceed:
(a) for total loss / constructive total loss of the vehicle -
the Insured's Declared Value (IDV)of the vehicle (including accessories thereon) as specified in the Schedule less the value of the wreck.
(b) for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle -
actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified.
Insurance company should settle the claim as per policy condition no. 03 of insurance contract.
Sir can I get ur no plz as need to clear 1 doubt plz
@@motorinsuranceclaimspracti4142 Sir I did not understood the above section as per your video I understand that if the repair cost exceed 75% of IDV then it can be declared total loss if it's below 75% the insurer can't refuse to repair is it right sir???
@@ashishthorat3342
आप मेरी email I'd ashok.1224@rediffmail.com के माध्यम से मेरी contact details ले सकते है।
During the accident , 06 people are seated in the car instead of 05 seater car,
Then my total loss claim is reject or not pls reply ASAP 🙏🙏
यदि accident की वजह overseating है तब तो क्लेम नहीं मिलना चाहिए। लेकिन यदि accident की वजह overseating नहीं है तो फिर तो यह claim मिलना चाहिए। यह fundamental breach का मामला नहीं होगा।
ऐसे मामले मे तो एक supreme court का निर्णय भी है, जिसमे क्लेम को सर्वोच्च न्यायालय के आदेश से pay किया गया है।
वैसे भी आप बीमा पालिसी या एप्रूवड सर्वेयर साहब से इस क्लेम को न मिलने का कारण, specific reason, बीमा पालिसी अनुबंध के अनुसार पूछियेगा।
उनसे पूछना की बीमा पालिसी अनुबंध की किस terms and conditions के violation के तहत यह क्लेम नहीं मिलना चाहिए।
Fact:-
Fundamental breach-
The Law of Insurance is based upon the contract of indemnity whereby the Insurer indemnifies the insured against the loss as per the terms and conditions stipulated in the contract and insurer cannot escape its liability unless there is a fundamental breach of contract resulting in repudiation of contract and not every breach.
Even if the insurance company is able to prove that there is breach of concerning policy conditions, the insurer would not be allowed to avoid its liability towards insures unless the said breach is so fundamental as to be found to have contributed to the cause of the accident.
AKS.G.N.
auto.economictimes.indiatimes.com/news/commercial-vehicle/mhcv/sc-vehicle-overloading-no-reason-to-deny-insurance/50517098
timesofindia.indiatimes.com/india/supreme-court-directs-insurance-firm-to-pay-rs-3-25-lakh-as-compensation-to-man-for-vehicle-damage-in-accident/articleshow/87133328.cms
Thanks u sir
Sir meri car new hai aur sirf 2 mahine hue h , zero dep insurance hai digit ka .abhi thoda accident ho gya to aage thoda damage ho gya . Phir gadi showroom me dedi aur jab verification k liye call aaya to galti se ghar ka nam bta dia , ab wo usi nam se driving licence mang rahe hai , ab ghar ke nam se driving licence hai nahi , ab wo approval nahi de rahe hain to kya karen , please bataye sir
आप बीमा कंपनी को email पर इसके लिए clarification दे दो।
और यदि बीमा कंपनी इसके बाद भी नहीं माने तो फिर बीमा कंपनी मे इसके लिए grievance दर्ज करना।
यदि बीमा कंपनी फिर भी नहीं माने तो फिर इसके लिए, बीमा लोकपाल आफिस मे शिकायत दर्ज कराना।
आप अपने घरेलू व असली नाम के लिए एक affidavit, एक अपने parents का नाम के विषय मे supporting letter व एक अपने करीबी पड़ोसी का घरेलू व असली नाम के समर्थन मे letter, बीमा कंपनी को भेजना।
मैन कुछ समय पहले बिलकुल इसी प्रकार का क्लेम deal किया था। यह क्लेम मे हमें बीमा लोकपाल आफिस के Award से न्याय मिल गया था, बीमा क्लेम मिल गया था। लेकिन यह क्लेम केस मे हमने गाड़ी अपने खर्चे पर शुरुआत मे ही ठीक करवा ली थी, लगभग 02-03 महीने बाद हमे बीमा क्लेम मिला था।
मैने जो अभी आपसे बताया था कि मैंने पहले आपकी इसी क्लेम की तरह एक claim को deal किया है, जो कि बीमा लोकपाल आफिस के निर्णय द्वारा बीमा धारक ग्राहक को मिला था।
वह क्लेम केस में भी, बीमा कंपनी go digit ही थी।
यदि आप अपनी ईमेल मुझे शेयर करेंगे तो मै आपको बीमा लोकपाल आफिस नोएडा का क्लेम केस मे award निर्णय आपको साझा कर दूँगा।
ashok.1224@rediffmail.com
Sir Mera gadi accident hoke 90day huwa abhi tak settlement nahi huwa. Bima wale bolrahe hai . investigation me chal Raha hai .... Kya kare sir 🙏
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
ashok.1224@rediffmail.com
बीमा कंपनी से लिखित मे delay के लिए शिकायत किजिए।
Sir mere pass mahindra pick up he is gadi ka accident hua tha repair approval de diya mere se repair ke sb paise bharwa diye ab pymt dene ka time aaya to bol rhe he ki gadi ka permit nhi he 3000 kg se jayada he hona chaye is karan se claim reject kr rhe he plz help sir
ashok.1224@rediffmail.com
Kya insurance company affidavit mang skte hai kya 3rd party ko koi nuksaan ni hai or koi FIR ni hue accident time
PTI,
NEW DELHI, ( AUGUST 01, 2014 18:41 IST
UPDATED: AUGUST 01, 2014 18:44 IST)
In a bid "" to save the common man from hassles"", Prime Minister Narendra Modi on Friday pushed for shifting to self-certification of documents and pitched for """minimum use of affidavits""".
""""In the landmark initiative, all ministries and departments at the Centre and in states have been asked to make provision for self-certification of documents in place of affidavits""".
The requirement of attestation by gazetted officers is sought to be replaced by self-certification by the citizen, a PMO statement said.
Under the self-certification method, the original documents are required to be produced at the final stage.
The Prime Minister, during his meeting with all Union Secretaries on June 4, had spoken of reforming the public service delivery system and bridging the governance deficit.
“""" This measure is a start in that direction. It is expected to benefit the people immensely, as all affidavits not required by law shall eventually be done away with,”""" the statement said.
In a communication addressed to all secretaries of the central government as well as Chief Secretaries of states and Administrators of Union Territories, the Department of Administrative Reforms and Public Grievances has noted that
"""“obtaining either an attested copy or "affidavit not only costs money to the poor citizen but also involves wastage of time of the citizens" as well as of the government officials.”"""
The Department has called for a review of the existing requirement of affidavits and attestation by gazetted officers, and replacement by self-certification.
"" In case of false self-certification, the person can be booked under relevant sections of the Indian Penal Code"".
""""" Getting an affidavit is a ''tough task'' for the "common man" """"".
"" People have to either shell out money to get affidavits from notary""
or approach a gazetted officer.
Gazetted officers are often reluctant to attest documents due to lack of documents.
बीमा पालिसी अनुबंध मे ऐसे किसी affadavit को देने की शर्त नहीं होती है। अलबत्ता यदि बीमा कंपनी को क्लेम के संबंध मे कुछ जानकारी चाहिए है तो वह plain paper पर बीमा धारक ग्राहक के statement के रूप मे ले सकती है, यह statement भी उतनी ही value रखता है।
यह 3rd party loss की जानकारी के लिए तो क्लेम फार्म में ही जानकारी होती है, वही पर इसको भरकर दिया जा सकता है। इसके लिए कोई no 3rd party loss जैसा कोई affadavit देने की आवश्यकता नहीं होती है।
लेकिन हमारे देश मे यह बेसिरपैर की माँग बहुत सी बीमा कंपनी मे या बहुत से सर्वेयर बंधुओं द्वारा की जाती है। सच तो यह है कि यदि 3ed party loss claim होगा तो वह बीमा कंपनी की जिम्मेदारी होगी, चाहे बीमा धारक ग्राहक ने इस प्रकार का affidavit भी दिया हो। बीमा कंपनी ऐसे affidavit से 3rd part के लिए अपनी जिम्मेदारी से नहीं बच सकती है।
हमारे देश के प्रधानमंत्री जी ने कहा था कि ये affidavit बनवाना, एक common आदमी के लिए wastage of time and wastage of money की प्रक्रिया है।
और यह बात बिलकुल सही है।
Sir,need one suggestion . Insurance company has approved the claim and sent the related confirmation to body shop to reapir the accidental vehicle .At the time of accident airbag did not opened so I reported this matter to maruti , insurance company and body shop.Now i am not getting any proper response from maruti .on every email and tweet maruti is saying concerned person will get in touch with you.its almost 15 days passed .pls suggest what to do .Regards
I have raised the below question from maruti, insurance company and car body shop:
My question is from the Maruti, GO Digit general Insurance Limited and Deep Motors .
1) I have purchased my vehicle in September 2021 and I drove it for around 6000 kilo meters only till the date of accident.
My question: Is this vehicle as good as new after repair ?
2) shall this vehicle perform as good as new if I drove it on high speed on highways .
3) I need an undertaking from Maruti, GO Digit general Insurance Limited and Deep Motors that this vehicle will be as good as new vehicle on high speed.
4) Maruti, GO Digit general Insurance Limited and Deep Motors shall give me warranty that this vehicle shall be as SAFE as a new vehicle .
If the above mentioned queries answer is not YES, then I request to kindly treat it as a total loss of accidental vehicle and provide me a new vehicle .
3. The Company may at its own option repair reinstate or replace the vehicle or part
thereof and/or its accessories or may pay in cash the amount of the loss or damage and
the liability of the Company shall not exceed:
(a) for total loss / constructive total loss of the vehicle - the Insured's Declared Value
(IDV) of the vehicle (including accessories thereon) as specified in the Schedule
less the value of the wreck.
(b) for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the
vehicle - actual and reasonable costs of repair and/or replacement of parts
lost/damaged subject to depreciation as per limits specified.
Insurance Policy contract wordings:-
STANDARD FORM FOR CMV PACKAGE POLICY
SECTION I. LOSS OF OR DAMAGE TO THE VEHICLE INSURED
The Company ""will indemnify"" the insured """against loss or damage to the vehicle insured"" hereunder and / or its accessories whilst thereon
vi. by accidental external means;
with terms & conditions.......
Principle of indemnity:-
"""The object of the principle is to place the insured after a loss in the same financial position as far as possible, as he occupied immediately before the loss"""".
According to Indian Motor Tariff 2002 -
GR.8. Insured,s Declared Value (IDV),
The Insured,s Declared Value (IDV) of the vehicle will be deemed to be the SUM INSURED for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle.
The IDV of the vehicle is to be fixed on the basis of manufacturer,s listed selling price of the brand and model as the vehicle proposed for insurance at the commencement of insurance /renewal and adjusted for depreciation (as per schedule specified below). The IDV of the side car(s) and / or accessories, if any, fitted to the vehicle but not included in the manufacturer,s listed selling price of the vehicle is also likewise to be fixed.
The schedule of age-wise depreciation as shown below is applicable for the purpose of Total Loss/ Constructive Total Loss (TL/ CTL) claims only.
""""""" A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and / or repair of the vehicle subject to terms and conditions of the policy exceeds 75% of the IDV"""".
NOTE:
IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles ( i.e. models which the manufacturers have discontinued to manufacture) is to be determined on the basis of an understanding between the insurer and the insured.
For the purpose of TL/CTL claim settlement, this IDV will not change during the currency of the policy period in question.
It is clearly understood that the liability of the insurer shall in no case exceed the IDV as specified in the policy schedule less the value of the wreck, in as is where is condition.
Sir, i need all the details for how to get surveyor licence. Please help.
Irdai की website पर जाकर बीमा सर्वेयर बनने के विषय मे जान सकते है। आप irdai की website से सर्वेयर रेगुलेशन 2015-20 को download कर सकते है, उसमे एप्रूवड सर्वेयर के बनने बारे मे पुरा procedure दिया हुआ है।
@@motorinsuranceclaimspracti4142 thanks you sir
@@motorinsuranceclaimspracti4142 sir what is the future of this profession .
How can I contact you sir …??
आप मुझे email लिखकर मेरी contact details ले सकते है।
मेरी email id-
ashok.1224@rediffmail.com
क्या ड्राइवर का नाम बदल सकते है, जो की हमने पहले से लिखित मे दिया है
ये सब जानकारी शुरूआत से ही सत्यता के अनुसार देनी होती है।
@@motorinsuranceclaimspracti4142 पर हमने तो गलत दे दिया, अब क्या करें
Sir mere pas spot ki pics hai but survivor bol rhe h spot survey kyu nhi krya plz help kya jawaab du main
Police report bhi hai mere pas or sari pics bhi or doctor mlr bhi
You can contact me,
ashok.1224@rediffmail.com
Sir Mera surveyor koi information nhi de rha
इसके लिए आपको एप्रूवड सर्वेयर व बीमा कंपनी दोनो से protection of policy holders interest gazette notification 2017 मे General insurance claim के तैय guidelines के अनुसार लिखित में जवाब माँगना चाहिए। एप्रूवड सर्वेयर साहब व बीमा कंपनी दोनो से सर्वे रिपोर्ट कापी, interim survey report copy आदि की माँग करनी चाहिए।
लेकिन यह सब माँग को लिखित मे ईमेल से करना। यदि ये आपको उचित जवाब नहीं देते है तो irdai, department of financial services आदि मे इस विषय में शिकायत करना।
Aaj rat ko kisi ne meri alto car jla di h ab kya mere ko claims milega ya nhi abi hmne insurance ko short circuit se jli hui batai h kya claim milega ya nhi
Please reply
बीमा पॉलिसी मे fire, malicious act, self ignition आदि perils कवरेज होती है। आपका बीमा क्लेम admissible होगा या नहीं होगा, यह बीमा पॉलिसी की terms and conditions पर निर्भर करेगा।
सच के साथ चलना महत्वपूर्ण होता है। आप एक तरफ लिख रहे है कि गाड़ी को रात मे किसी न आग लगा दी, जबकि दूसरी तरफ आपने बीमा कंपनी को short circuit के कारण आग लगना बताया है। यह मेरी समझ से परे है।
मेरा मानना है कि सच व सही के साथ चलना ही बेहतर होता है।
Hme pta nhi h kya hua h rat ko but supposed kr rhe car piche se jli h esliye anuman lga rhe h
@@ravisinghal4499
तो फिर वही statement होना चाहिए, ऐसा मेरा मानना है। statement मे बदलाव सही नहीं है। जैसे आपको पता ही नही है लेकिन आपने मुझे बताया था कि किसी ने रात मे गाड़ी मे आग लगा दी। आपने ही मुझे बताया कि आपने बीमा कंपनी को short circuit के कारण आग लगने बताया।
जबकि आपके अनुसार अपको यह तो पता है कि गाड़ी मे आग लगी है, लेकिन कैसे किस वजह से लगी है, यह जानकारी नहीं है।
मेरा मानना है कि आपको यही सबको बताना चाहिए। statement मे बदलाव संदेह पैदा करता है।
Sir namaskar
Yhi sb mare sath hua hai mai ab kya kru
आपको जानना होगा कि, बीमा नियमों के सापेक्ष, आपकी बीमा पालिसी अनुबंध के सापेक्ष व बीमा नियमों के सापेक्ष, आपके साथ क्या क्या गलत हो रहा है। आपको इन गलत के लिए बीमा कंपनी व higher authorities को सही तरीके से ( लिखित में ईमेल आदि से) शिकायत करनी होगी। अपना वाजिव हक पाने के लिए प्रयास करना होगा।
Sir same condition mere sath ho rhi he 1 month ho gya hai. investigation chal raha bs yahi bolte rhte he me kya Kru ??
बीमा कंपनी , irdai officials व संबंधित Authorities को delay in settlement के लिए लिखित में शिकायत करो।
इस क्लेम केस में नियुक्त एप्रूवड सर्वेयर साहब से क्लेम एप्रूवल मे देरी की वजह लिखित मे पूछो व इसके लिए शिकायत करो।
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
Sir I just want to ask on thing that can a surveyor send his subordinate who don’t have any surveyor license on his behalf to inspect the accident scene and to insured to fill up the forms and ask for documents like call records Google timeline and driving license of the persons other than driver in the accident claim case.
Sir mere car ka claim reject kiya kyu ki maine galat NCB select kiya tha. Kya karu sir please help
आप बीमा कंपनी के chief grievance officer को इस विषय मे लिखित शिकायत किजिये।
इसके बाद बीमा कंपनी आपको कुछ प्रतिशत काटकर क्लेम देने के लिए तैयार हो सकती है।
यदि फिर भी बीमा कंपनी क्लेम देने को तैयार नहीं होती है, तो फिर आप इसके लिए बीमा लोकपाल आफिस में शिकायत दर्ज कर सकते है, वहां से आपको न्याय मिल सकता है।
@@motorinsuranceclaimspracti4142 Thank you very much sir for reply. Maine consumer forum me complaint dal di hai. Jaise apne suggest kiya waise me Chief Gravience officer ka mail id dhundne ki koshish karta hun
@@amitpatil6313
आप पहले बीमा लोकपाल आफिस में शिकायत कर सकते थे, वहां पर कुल 90 days का समय सुनवाई व result के लिए होता है।
Sir mere bike la accident ho gya claim ke liye process on he lekin abhi tak hua nhi hai plz reply sir
बताइये साहब, मै आपकी क्या मदद कर सकता हूँ
@@motorinsuranceclaimspracti4142 Sir aapka mobile no send karo
@@poteakshay1912
आप अपना नंबर लिख दो तो मै आपसे संपर्क कर लूँगा। मै यहाँ पर अपना नंबर नहीं लिखता हूँ।
Claim amount kitne din me account me aati hai?
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
आप बीमा कंपनी से इस विषय मे पूछ सकते है। आप क्लेम सैटलमैट के लिए तैय समय सीमा को protection of policy holders interest gazette notification 2017 मे General Insurance claims के लिए तैय guidelines से जान सकते है।
Sir mujhe help chahiye ek please 🙏 insurance walo ne meri car ka claim reject kr diya investigatr ne glt report lga di
ashok.1224@rediffmail.com
आप इसके लिए बीमा कंपनी मे शिकायत कर सकते है। आप इसके लिए फिर irdai में शिकायत कर सकते है, फिर आप बीमा लोकपाल में शिकायत कर सकते है, फिर आप department of financial services, pmo, centeral government public Grievance में शिकायत कर सकते है, फिर आप उपभोक्ता फोरम मे शिकायत कर सकते है, फिर आप न्यायलय में शिकायत कर सकते है।
Kya kya upay h
यह क्लेम केस के लिए proper way मे, बीमा नियमों के सापेक्ष, बीमा कंपनी व संबंधित higher authorities को शिकायत की थी।
इसके बाद बहुत ही जल्दी बीमा कंपनी ने यह क्लेम settle कर दिया था।
Protection of policy holders interest gazette notification 2017,-
15. CLAIM PROCEDURE IN RESPECT OF A GENERAL INSURANCE POLICY
1. An insured or the claimant shall give notice to the insurer of any loss arising under contract of
insurance at the earliest or within such extended time as may be allowed by the insurer. On receipt of
such a communication, a general insurer shall respond immediately and give clear information to the
insured on the procedures that he should follow. In cases where a surveyor has to be appointed for
assessing a loss/claim, it shall do so immediately, in any case within 72 hours of the receipt of
intimation from the insured. Insurer shall communicate the details of the appointment of surveyor,
""""including the role, duties and responsibilities of the surveyor to the insured by letter, email or any
other electronic form immediately after the appointment of the surveyor"""".
2. The insurer / surveyor shall within """"7 days of the claim intimation, inform the insured / claimant of the
essential documents and other requirements that the claimant should submit in support of the claim""""".
Where documents are available in public domain or with a public authority, the surveyor/insurer shall
obtain them.
3. The surveyor shall start the survey immediately unless there is a contingency that delays immediate
survey, in any case within 48 hours of his appointment. Interim report of the physical details of the
loss shall be recorded and uploaded/forwarded to the insurer within the shortest time but not later than
15 days from the date of first visit of the surveyor. """"A copy of the interim report shall be furnished by
the insurer to the insured/claimant, if he so desires"""".
4. Where the insured is unable to furnish all the particulars required by the surveyor or where the
surveyor does not receive the full cooperation of the insured,
"""" the insurer or the surveyor, as the case
may be, shall inform in writing to the insured under information to the insurer about the consequent
delay that may result in the assessment of the claim""" .
"""" It shall be the duty equally of the insurer and the
surveyor to follow up with the insured for pending information/documents guiding the insured with
regard to submissions to be made"""".
"""" The insurer and/or surveyor shall not call for any
information/document that is not relevant for the claim""""".
5.
(i) The surveyor shall, subject to sub-regulation 4 above, submit his final report to the insurer within 30 days of his appointment.
""""A copy of the surveyor’s report shall be furnished by the
insurer "to the insured/claimant", if he so desires"""".
Notwithstanding anything mentioned herein, in
case of claims made in respect of commercial and large risks the surveyor shall submit the final
report to the insurer within 90 days of his appointment. However, such claims shall be settled by the
insurer within 30 days of receipt of final survey report and/or the last relevant and necessary
document as the case may be.
(ii) Where special circumstances exist in respect of a claim either due to its special /
complicated nature, or due to difficulties associated with replacement/reinstatement, the surveyor
shall, seek an extension from insurer for submission of his report. """"In such an event, the insurer
shall give the status to the insured/claimant fortnightly wherever warranted""". The insurer may
make provisional/ on account payment based on the admitted claim liability.
6. If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall
require the surveyor, under intimation to the insured/claimant; to furnish an additional report on
certain specific issues as may be required by the insurer. Such a request may be made by the insurer
within 15 days of the receipt of the final survey report.
Provided that the facility of calling for an additional report by the insurer shall not be resorted to more than
once in the case of a claim.
7. The surveyor, on receipt of this communication, shall furnish an additional report within three weeks
from the date of receipt of communication from the insurer.
8. On receipt of the final survey report or the additional survey report, as the case may be, and on receipt
of all required information/documents that are relevant and necessary for the claim, an insurer shall,
with in a period of 30 days offer a settlement of the claim to the insured/claimant. If the insurer, for
any reasons to be recorded in writing and communicated to the insured/claimant, decides to reject a
claim under the policy, it shall do so within a period of 30 days from the receipt of the final survey
report and/or additional information/documents or the additional survey report, as the case may be.
9. """" In case, the amount admitted is less than the amount claimed, then the insurer shall inform the
insured/claimant in writing about the basis of settlement in particular, where the claim is rejected, the
insurer shall give the reasons for the same in writing drawing reference to the specific terms and
conditions of the policy document""".
10. """In the event the claim is not settled within 30 days as stipulated above, the insurer shall be liable to
pay interest at a rate, which is 2% above the bank rate from the date of receipt of last relevant and
necessary document from the insured/claimant by insurer till the date of actual payment""".
19. GENERAL PRINCIPLES:
6. Any breach of the obligations cast on an insurer or distribution channels or surveyors in terms of these
regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under
the Act and/or the Insurance Regulatory and Development Authority Act, 1999.
आपको protection of policy holders interest gazette notification 2017 में General insurance claim guidelines को पढ़ कर समझ कर यह जान लेना है कि बीमा कंपनी आपके क्लेम मे क्या गलत कर रही है।
उसके बाद उस विषय मे बीमा कंपनी के chief grievance officer को irdai officials को, dfs officials को proper way में शिकायत करनी है।
यदि एप्रूवड सर्वेयर साहब सही से, निष्पक्षता से, आजादी से, सर्वेयर रेगुलेशन 2015-20 में तैय एप्रूवड सर्वेयर की duties and responsibilities, code of conduct के दायरे में, सही समय सीमा मे कार्य नहीं कर रहे है तो आप इस विषय मे भी इन्ही उपरोक्त को proper way में शिकायत कर सकते है।
Sir my surveyor is not responding it's has been 45 days still no report
Plz suggestions
You should send a proper complaint in this regard to the insurance company and the concerned authorities in writing as per the Surveyor Regulation 2015-20.
Sir ji I am very excited to work as an investigator.... please give me some opportunity......
My car Total loss , declared on 9 oct, clame 433000 . But insurance company giving me 1,38000 and told me rest of money i will get from salvage buyer as company had online auctions the car with RC.
What shall i do.
They haven't given me anything writing
As per IRDAI Circular-CircularRef. No:IRDAI/NL/CIR/MOTOD/118/07/2019Date:26-07-2019Misuse of Total Loss Accident Vehicle Documents over Stolen VehiclesTo,
ALL GENERAL INSURERS (OTHER THAN STAND-ALONE HEALTH INSURERS AND SPECIALISED INSURERS)
Re: - Misuse of Total Loss Accident Vehicle Documents over Stolen Vehicles
It has come to the notice of Authority that in case of Total Loss (TL) of the vehicle, salvage of the vehicle is being sold to scrap dealers without cancelling Certificate of Registration (RC) of the vehicle.
2. It has been informed by the Law Enforcement Authorities that documents pertaining to such vehicles are being misused like giving new identity to the stolen vehicles by forging engine number and chassis number of destroyed vehicles under TL claims.
3. As per Section 55 of Motor Vehicle Act 1988,
(1) If a motor vehicle has been destroyed or has been rendered permanently incapable of use, the owner shall, within fourteen days or as soon as may be, report the fact to the registering authority within whose jurisdiction he has the residence or place of business where the vehicle is normally kept, as the case may be, and shall forward to the authority the certificate of registration of the vehicle.
(2) The registering authority shall, if it is the original registering authority, cancel the registration and the certificate of registration, or, if it is not, shall forward the report and the certificate of registration to the original registering authority and that authority shall cancel the registration.
4. In view of the above, all insurers are advised to ensure cancellation of Certificate of Registration (RC) of the vehicle in case of total loss claim settlement.
Yours faithfully,
(Yegnapriya Bharath)
Chief General Manager (NL)
According to Indian Motor Tariff 2002.
STANDARD FORM FOR PRIVATE CAR PACKAGE POLICY :-
Policy condition 03-
3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and the liability of the Company shall not exceed:
(a) for total loss / constructive total loss of the vehicle - the Insured's Declared Value (IDV) of the vehicle (including accessories thereon) as specified in the Schedule less the value of the wreck.
(b) for partial losses, i.e. losses other than Total Loss/Constructive Total Loss of the vehicle - actual and reasonable costs of repair and/or replacement of parts lost/damaged subject to depreciation as per limits specified.
It is illegal activity. You should ask the claim settlement offer in writing from insurance company.
As per IRDAI Circular-Circular
Ref. No:IRDAI/NL/CIR/MOTOD/118/07/2019
Date:26-07-2019
"""Misuse of Total Loss Accident Vehicle Documents over Stolen Vehicles"""
To,
ALL GENERAL INSURERS (OTHER THAN STAND-ALONE HEALTH INSURERS AND SPECIALISED INSURERS)
Re: - Misuse of Total Loss Accident Vehicle Documents over Stolen Vehicles
It has come to the notice of Authority that in case of Total Loss (TL) of the vehicle, salvage of the vehicle is being sold to scrap dealers without cancelling Certificate of Registration (RC) of the vehicle.
2. It has been informed by the Law Enforcement Authorities that documents pertaining to such vehicles are being misused like giving new identity to the stolen vehicles by forging engine number and chassis number of destroyed vehicles under TL claims.
3. """ As per Section 55 of Motor Vehicle Act 1988,
(1) If a motor vehicle has been destroyed or has been rendered permanently incapable of use, the owner shall, within fourteen days or as soon as may be, report the fact to the registering authority within whose jurisdiction he has the residence or place of business where the vehicle is normally kept, as the case may be, and shall forward to the authority the certificate of registration of the vehicle.
(2) The registering authority shall, if it is the original registering authority, cancel the registration and the certificate of registration, or, if it is not, shall forward the report and the certificate of registration to the original registering authority and that authority shall cancel the registration.
4. In view of the above, all insurers are advised to ensure cancellation of Certificate of Registration (RC) of the vehicle in case of total loss claim settlement.""""
Yours faithfully,
(Yegnapriya Bharath)
Chief General Manager (NL)
According to Indian Motor Tariff 2002.
GR.8. Insured‟s Declared Value (IDV)
The Insured‟s Declared Value (IDV) of the vehicle will be deemed to be the „SUM INSURED‟ for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle.
The IDV of the vehicle is to be fixed on the basis of manufacturer‟s listed selling price of the brand and model as the vehicle proposed for insurance at the commencement of insurance /renewal and adjusted for depreciation (as per schedule specified below). The IDV of the side car(s) and / or accessories, if any, fitted to the vehicle but not included in the manufacturer‟s listed selling price of the vehicle is also likewise to be fixed.
"""" A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and / or repair of the vehicle subject to terms and conditions of the policy exceeds 75% of the IDV"""".
NOTE:
IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles ( i.e. models which the manufacturers have discontinued to manufacture) is to be determined on the basis of an understanding between the insurer and the insured.
For the purpose of TL/CTL claim settlement, this IDV will not change during the currency of the policy period in question.
It is clearly understood that the liability of the insurer shall in no case exceed the IDV as specified in the policy schedule """"""less the value of the wreck"""""", in „as is where is‟ condition.
Sir i want to contact...
ashok.1224@rediffmail.com
Sir,plz give me ur contact no..
@@amitji52
ashok.1224@rediffmail.com
Please share your contact number.. because you are totally given wrong statement..I want take your statement regarding the same ..on you tube ..
मै नहीं जानता कि आप कौन है। आपका मानना किसी भी विषय पर मुझसे अलग हो सकता है। मेरा जो कुछ भी मानना है वह बीमा नियमो के अनुसार है। मुझे आपसे जानने व समझने की कोई जरूरत ही नहीं है। मै स्वयं भी एक qualified Approved Surveyor हूँ।
धन्यवाद।
Fffbnm
Sar ji muje aap ka mobile no. Chahiye
आप मुझे मेरी email id ashok.1224@rediffmail.com पर email करके मुझसे मेरी contact details ले सकते है।
Sir pl mo no dijiya
ashok.1224@rediffmail.com
Sir aapka mobile no send karo. Plzzz muze Help. Chaiye claim ke bare main jankari
आप मुझे मेरी ईमेल I'd पर अपनी contact details भेज देना, उस पर मै अपना फोन नंबर व अन्य जानकारी साझा कर दूँगा।
ashok.1224@rediffmail.com
Sir please aap apna phone nom. Send kre
आप मुझे मेरी email id ashok.1224@rediffmail.com पर संपर्क कर सकते है, फिर मै आपको आपकी email पर अपनी contact details भेज दूंगा
आपने मुझसे पहले भी मेरा फोन नंबर मांगा था। मै यहाँ You tube पर privacy के नजरिए से अपना फोन नंबर नहीं लिखता हूँ।
आप मुझसे मेरी email id ashok.1224@rediffmail.com के द्वारा संपर्क कर सकते है। आप मुझे ईमेल करेंगे तो मै आपको अपनी पुरी contact details भेज दूंगा।
सर बहुत बहुत धन्यवाद आपका जो आपने हमे ये जानकारी दी। मेरी गाड़ी भी एक्सीडेंट हुई थी। सर्वेयर साहब भी mughe यही बात कह रहे है की investigetion लगा है।कोई inqari नही मेरी गाड़ी को डेढ़ महीना हो गया है । मेरी comrceal गाड़ी है किस्त मै घर से भर रहा हु।मै गरीब आदमी हु ।मेरा परिवार गाड़ी की कमाई से चलती है। मै क्या करू सर। बहुत parishan हु। प्लीज