Pushpa Girimaji
WHENEVER you buy an insurance policy, make sure that you read the policy conditions carefully and follow them stringently. I say this with particular reference to motor insurance claims where clients have lost out only because they failed to fulfil some simple policy conditions. Let us look at insurance claims pertaining to theft of a vehicle.
In all such cases, clients have to fulfil two important but simple policy conditions: (a) report to the police about the theft immediately; and (b) inform the insurance company without any delay.
In a case that came up before the apex court some time ago, for example, the main issue was whether the insurance company was right in rejecting the claim on the ground that the consumer had failed to report the theft of his truck to the police for several months.
It was quite possible that the aggrieved person was doing his own investigations and was sure of tracing the vehicle, and, therefore, did not file a first information report with the police. Whatever the reason, eventually, when he filed his claim papers, one of the first objections raised by the insurance company was that he had not reported the theft to the police immediately and, therefore, the claim ought to be rejected. The apex court, too, agreed with this view.
Now in a recent case decided by the national consumer disputes redressal commission, the central issue was whether the insurance company was justified in rejecting a claim on the ground that the consumer did not report the loss of vehicle to the insurance company immediately. In this case, following the theft of the vehicle parked in front of his house, the client lodged a police complaint without any delay. But he did not report the theft to the insurance company. He might have thought that he needed to inform the police only. It is also obvious that he was not aware of the policy condition. So when he eventually asked the insurance company to make good his loss—the vehicle was insured for Rs 1.85 lakh—the insurance company pointed to condition number 1 of the policy, which required the customer to inform the insurance company of the theft immediately, and said it was, therefore, rejecting the claim. The district consumer disputes redressal forum, before which the client had filed a complaint, came to his rescue and said since the theft was established and the police had closed the case, saying that the car could not be traced, the insurer was not right in repudiatingthe claim.
However, on the ground that the consumer had violated the policy condition and reported the theft to the insurance company only four months after its occurrence, it directed the insurer to settle the claim on non-standard basis at 75 cent of the loss. It also directed that the insurer pay 12 per cent interest on the amount. (Oriental Insurance v. Parvesh Chander Chadha, RP No 496of 2005).
Thus, for a theft that had taken place in January, 1995, the aggrieved person had to fight a long legal battle spanning over 13 years, and even then, got only 75 per cent of the claim amount, all because he had not followed a simple policy condition of writing to the insurance company about the theft.
So, whatever the policy, always read the conditions stipulated in the policy and follow them without fail. Of course, if the conditions are patently unfair, then you can always bring these to the notice of the Insurance Regulatory and Development Authority (IRDA). The courts may also come to your aid if you have failed to follow a condition that is highly unfair and one-sided. But there is no escape in so far as certain basic policy conditions such as reporting the matter to the insurance company and the police are concerned.
In all such cases, clients have to fulfil two important but simple policy conditions: (a) report to the police about the theft immediately; and (b) inform the insurance company without any delay.
In a case that came up before the apex court some time ago, for example, the main issue was whether the insurance company was right in rejecting the claim on the ground that the consumer had failed to report the theft of his truck to the police for several months.
It was quite possible that the aggrieved person was doing his own investigations and was sure of tracing the vehicle, and, therefore, did not file a first information report with the police. Whatever the reason, eventually, when he filed his claim papers, one of the first objections raised by the insurance company was that he had not reported the theft to the police immediately and, therefore, the claim ought to be rejected. The apex court, too, agreed with this view.
Now in a recent case decided by the national consumer disputes redressal commission, the central issue was whether the insurance company was justified in rejecting a claim on the ground that the consumer did not report the loss of vehicle to the insurance company immediately. In this case, following the theft of the vehicle parked in front of his house, the client lodged a police complaint without any delay. But he did not report the theft to the insurance company. He might have thought that he needed to inform the police only. It is also obvious that he was not aware of the policy condition. So when he eventually asked the insurance company to make good his loss—the vehicle was insured for Rs 1.85 lakh—the insurance company pointed to condition number 1 of the policy, which required the customer to inform the insurance company of the theft immediately, and said it was, therefore, rejecting the claim. The district consumer disputes redressal forum, before which the client had filed a complaint, came to his rescue and said since the theft was established and the police had closed the case, saying that the car could not be traced, the insurer was not right in repudiatingthe claim.
However, on the ground that the consumer had violated the policy condition and reported the theft to the insurance company only four months after its occurrence, it directed the insurer to settle the claim on non-standard basis at 75 cent of the loss. It also directed that the insurer pay 12 per cent interest on the amount. (Oriental Insurance v. Parvesh Chander Chadha, RP No 496of 2005).
Thus, for a theft that had taken place in January, 1995, the aggrieved person had to fight a long legal battle spanning over 13 years, and even then, got only 75 per cent of the claim amount, all because he had not followed a simple policy condition of writing to the insurance company about the theft.
So, whatever the policy, always read the conditions stipulated in the policy and follow them without fail. Of course, if the conditions are patently unfair, then you can always bring these to the notice of the Insurance Regulatory and Development Authority (IRDA). The courts may also come to your aid if you have failed to follow a condition that is highly unfair and one-sided. But there is no escape in so far as certain basic policy conditions such as reporting the matter to the insurance company and the police are concerned.
Source:-Sunday, November 23, 2008 Spectrum The Tribune
http://www.tribuneindia.com/2008/20081123/spectrum/rights.htm
http://www.tribuneindia.com/2008/20081123/spectrum/rights.htm
For any query:- legalpoint@aol.in
No comments:
Post a Comment