CLAIM FILE REFERRAL/INSTRUCTION/COMMENT FORM

Date Comment/Opinion/Instruction…etc
12/08/2023 Decision request(Average contribution waiving/Any other decision approval)
i. It’s to be recalled that Insured’s vehicle plate no 2-B96979 AA was
sustaining an accident. Prices were established and communicated to them
accordingly. The sum insured of the vehicle becomes less than current
market value by average application of 84.62% (i.e.
1,650,000.00/1,950,000.00*100%=84.62%) of total repairing has approved.
But the client is complaining on average by stating, they aggressively
encourages their clients to purchase insurance from our company and we
imposed on by stating as she renewed the policy based on the market value
& Accordingly we tried to get premium collected for the last five (5) years
and basis of sum insured from the branch (Please kindly refer p#41-44),
then the loss ratio made and it is 80.69% %(Please kindly refer p#43).
ii. In addition to this the vehicle is completed repairing and finalization was
seen and the salvage item was collected for the fuel tank. Then after, the
insured requested us additional mechanical assessment. Kindly refer
#38.Based on his complain we were requesting the mechanical assessment
from engineering division and it was inspected the mechanical assessment
by our surveyors and ordered to change filter kit. Kindly, refer page
#39&40.but the replacement was done without the company permission and
as engineering refer the damage was related with the accident.
Hence, the file is presented to any decision /direction approval as the
information provided above and the detail attached with the file.
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