Claims

Management

MARINE INSURANCE CLAIMS

Marine insurance claims can be broadly
categorized into Marine cargo
Marine hull
Ocean going vessels
Sundry hulls

FIRE INSURANCE CLAIMS

The main documents generally required for
processing fire claims are: Claim form duly completed by the insured.
Copies of the policy complete with terms,
conditions and warranties.
Photographs (if necessary)
Police report and (if necessary)
Fire brigade report (if necessary)
Where the loss estimate is more than Rs. 1
crore, intimation is to be sent to tariff
Advisory committee ( TAC )

MOTOR INSURANCE CLAIMS

Motor insurance claims are broadly categorized into:
1. Own-Damage claims, and
2. Third party claims.
Own-Damage claimsImmediately on receipt of intimation of loss, either in
writing or over telephone, a surveyor should be
appointed based on the estimate of repairs.

The documents generally required for settlement of motor

claims are:
Photographs of the vehicle at the spot of the accident,
showing all
the external damages and the number plate of the
vehicle.
Claim form duly filled in.
Registration Certificate
Driving License
Load Challan/Trip Sheet
Fitness Certificate
Copy of the FIR
Survey Report
In case of partial loss claims, submission of bills can be
dispensed with for claims up to Rs.50,OO0 in respect of
private cars and two wheelers only, subject to:
o The Survey Report indicating the cost of parts allowed for
replacement.

THEFT CLAIMS
Theft claims are either total loss claims or partial loss
claims. If claims settling authority is not fully satisfied,
investigation of the theft to be arranged by an investigator
who may be appointed with specific terms of reference.
The following documents should be collected from the
insured
in addition to a certified copy of FIR:
Surrender of the Registration Book and the Tax Book to
the
insurer duly transferred in the name of the insurers.
Ignition keys of the vehicle
Certificate of insurance and the original insurance policy,
if
not stolen with the vehicle.
Specially worded discharge voucher.
If the vehicle is recovered subsequently the insured will
have the option to repay the claim amount already paid

THIRD PARTY CLAIMS

The procedure for settling third party claims is broadly on the
following lines:
Intimation of Claim: Intimation about an accident resulting into third
party claim is received through various sources:
Insured
Claimant
Courts by notice
Through accident report from police in Form 54 prescribed under
Central Motor Vehicle Rules, 1989.
Investigation: Investigation about the accident to collect the relevant
data to quantify reasonable and just compensation as per the formats
enclosed in respect of all third party claims is mandatory.
Appointment of Advocate: A competent advocate may be appointed if
necessary to ensure that the proper defence is taken where necessary and
no frivolous statements are made.
In the case where the fault of the driver is not proved, company should take
immediate steps to deposit No Fault Liability amount as per section 140 of
the MV Act, 1989.

MISCELLANEOUS
INSURANCE CLAIMS
Miscellaneous Accident Insurance includes a number of covers,
which are in the nature of package policies. In this situation specific
guidelines applicable to the representative sections are to be
followed.
BURGLARY INSURANCE
The following documents are important while processing burglary
insurance:
Duly completed claim form
Final investigation report from the police
Survey Report
Photographs
It is considered preferable to appoint an investigator with surveyors
license and knowledge of accounts as assessment of losses
sometimes involves checking books of accounts.

WORKMEN'S COMPENSATION
INSURANCE
The necessary documents for processing workmen's
Compensation claims include:
Medical Certificate.
Wages statement.
Proof of age as recorded by the employer.
For the permanent total disablement claims, the memorandum
of agreement is required to be submitted to the workmen's
compensation commissioner while disposing compensation as per
Workmen's Compensation Act.
For total claims, the perusal of death certificate and postmortem
report is important before depositing the amount with workmen's
compensation commissioner.

MEDICLAIM
The following documents are
required:
Duly completed claim forms
Bills, receipts and discharge
card
from the hospital
Cash memos from the
hospital
Bills from chemists supported
by proper prescription
Surgeons bills and receipts,
bills from pathologist
supported by proper
prescription