Motor Insurance Claim Rejected ? 

 

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 Just few days back in motor accident the bike owner lost his life. He was driving Royal Enfield Bullet 350 CC. The Insurance company rejected his claim. The reason that under the insurance policy the vehicle enging cubic capicity was 150 cc. hence the insurance company is not liable to pay the claim as the said vehicle was 350 cc. This agent was forced to reduce the premium as the owner demanded discount in policy and wanted to pay low premium.

Anyhow with intention towards lowering the premium the agent was forced to find a way to reduce the CC of the proposed vehicle where the premium would be low.

After few months of the Insurance policy period the Policyholder met with an accident, where he died on the spot. The insurance claim was rejected as the vehicle was 350 CC and not 150. This maybe the case of Misselling by Agent. 

But many a time the Car owner of Bike owner do not check the policy, which theyshow do at least once when policy is received.

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Reasons for rejections:

Grounds for refusal Insurance claims for vehicles, whether cars or two-wheelers, are only accepted if the damage is accidental, due to natural disasters, theft or accidental fire.

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Other common reason for claim rejection

Ignorance of Policy and Additional Coverage: A common reason for claim denial and grouse is that certain specific damages are not covered by the policy and for these, separate additional coverage must be purchased. “For eg, engine damage or loss of depreciation is not covered in the base policy and separate engine protections and additional coverage without depreciation are required.

Car or Bike sent for repairs. immediately after accident.

Most common mistake that immediately after accident the vehicle is repaired on your own. Actually one should inform the Insurance company immediately. As it makes difficult for an insurance company to access the loss/damage.

Disclosures.

At the time of buying vehicle insurance or renewing the policy all the material facts to be disclosed such as pre-existing damages or claims in previous year. So if one forgets or misrepresents the previous claim notification for current insurance policy, then also at the time of claim it gets regected due to misrepresentation clause under the policy.

Insurable Interest.

At the time of accident or damage one has to prove that the claim amount or the indemnity to be provided to the Owner of the vehicle. I another words, if owner fails to transfer the Registration number in his/her name. In such case the claim will be repudiated.

Modification of Vehicle.

If you are installing a GNC kit in your car, add accessories or make changes to the vehicle organization, you must immediately inform the insurer, otherwise your accident complaint will not be approved.

Driving without valid driving licence.

If the person driving the vehicle does not have a driver's license at the time of the accident, the report will be rejected. In addition, he / she must be in possession of a valid license, not expired and for the type of vehicle for which it is intended. For example, if you only have a license to drive a two-wheeler but have an accident while driving a car, the claim will be denied.

Drink and drive.

Another obvious reason for denying the request is drunk driving. As it is illegal to drive under the influence of alcohol in India, any claims resulting from an accident caused by drunk driving will be rejected.

Delayed claim intimation.

If you refer to informing the insurer of the accident, it is possible that your request will be refused. The deadline is short, usually 24-48 hours, and you must make sure to notify the insurer within this period.

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चार महीनों में 1,16,00,000 कमाकर अपने सपनों की कार खरीदी- निवेश केवल 5000 रुपये 

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You must know the exclusions.

A basic insurance policy covers only the accidental damage of the body and the engine.

In addition, damage due to the insured or third parties and not due to an uncertain event is not covered. “For example, engine damage from hydrostatic loss during monsoons is common. Here, the damage does not occur due to flooding or rain, but because someone turned on the car in a flooded area. This is not covered by som insurance co's.

Things like engine oil or lubricants are not covered by the base policy, nor are plastic parts or tires. Any damage caused to the vehicle during normal use, such as worn tires or tubes and mechinical, electrical breakdown is not covered.

Important:

If the loss or damage is too small for example in car insurance if you have loss of Rs.2000 due to accidental damage, then first confirm the excess under the policy then only proceed for the claim procedure. As the excess coud be from anywhere from Rs.1500 and upwards. And if you claim then you will receive only Rs.500 further in the next due renewal you will lose the No Claim bonus, in turn will have to pay higher premium.

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