There is no cover for insurance claims. The claimant may not get a reasonable settlement or the settlement could be delayed. It's very important for the consumer to adhere to the stipulated procedure, and complete the necessary formalities before filing a claim to rule out such an eventuality.In the event of a theft, the policy holder shouldn't only lodge an FIR with the police, but also try to procure a copy of the report. And, if necessary, cooperate with the police in apprehending the guilty and recovering the stolen property. Intimation about a stolen motor vehicle may be given to the regional transport officer as well.
The consumer doesn't have to act only after the occurrence of an event. In the case of a fire, he is supposed to call the fire brigade immediately and try to contain the damage. The insurer even requires that the damaged goods be kept in safe custody for survey. Cooperation with the surveyor in assessing the loss or damage is also desirable.
Whether it is theft or fire, the policyholder must inform the insurer immediately in person, by phone or telegram. The claim along with full particulars of the loss and substantiating documents is to be submitted within 14 days.
And if there is an accident, the injured person is advised to get medical treatment immediately. The insurer needs to be notified about an injury within 14 days of the day of occurrence. The time limit is one month in case there is loss of sight or amputation of limbs. The medical papers and all other relevant documents, such as bills, should be appended with the claim to substantiate it.
But the policy holder is not entitled to any claim if he is driving without a valid driving licence or in an intoxicated state or using the vehicle for an illegal activity, all of which are punishable.
At the same time, the claimant must refrain from repairing the damaged property without the consent of the insuring company. Similarly, no responsibility is to be accepted or repudiated in the event of liability drawn by others.Remember, the insurer defends accident cases, except criminal ones, in court.
Whenever there is a dispute about the claimed amount, the case is referred for arbitration under the provisions of the Indian Arbitration Act, 1940. The arbitrator gives an award usually within four months. But the case can't be referred for arbitration if the insurer doesn't accept the liability in the first place.
In such cases of faulty or inadequate service, the aggrieved person should approach a consumer court. He can also complain to the court if the settlement of an insurance claim is delayed. But, whether an appeal is made to the insurer, an arbitrator or a court, it helps if the claimant has followed the stipulated instructions, and preserved all the relevant documents.
Copyright © 1998 Indian Express Newspapers (Bombay) Ltd.
