Mr Ajay a Company Secretary is also a fellow member of The Insurance Institute of India. He joined ABC Limited as a Manager in 2006 and got promoted as a Senior Manager in October, 2011. His promotion entitled him to buy
CS Professional · Insurance - Law and Practice · PYQS · December 2017
Mr Ajay a Company Secretary is also a fellow member of The Insurance Institute of India. He joined ABC Limited as a Manager in 2006 and got promoted as a Senior Manager in October, 2011. His promotion entitled him to buy a car. He bought a Hyundai EON car. He took lessons from a driving class and got a Learner's Driving licence. The car purchased and registered in October 2011 was insured with FG Insurance comprehensively. During December, 2011 while reversing his new car (EON) parked on a gradient facing west east inside the company's car shed lost control over the vehicle and dashed the rear of an Esteem Vehicle (parked East West). Due to the impact ESTEEM vehicle had also touched another car Santro nearby. Esteem car was insured by the owner comprehensively with TAIG Insurance. Mr Ajay immediately informed the security of the company ABC Limited as the parking shed belonged to ABC Limited and the executives and managers were authorised to park their vehicles in the big parking shed partly open and partly covered with asbestos sheets. Mr Ajay the insured had only a LLR (Leaner's Licence) and yet to get a permanent driving licence. However at the time of accident he was accompanied by Mr. Sanjay who was having a permanent driving licence and sitting adjacent to Mr Ajay while he was driving. Mr Sanjay drove the vehicle after the accident to the dealer cum repairing centre and left the vehicle at dealer's garage to have the vehicle repaired. As there was no injury to any person and the accident happened inside the parking shed owned by ABC Limited, it never occurred to Mr Ajay that he should lodge a FIR/Panchnama. Mr Ajay took moral responsibility in taking the lead and reported the claim to TAIG Insurance (Insurer of ESTEEM) after ascertaining the name of the insurer and the insured from the records available with ABC Limited. As the ESTEEM vehicle was very old vehicle, total repair expenses exceeded the assessment of the surveyor and Mr Ajay had to reimburse ₹10000/- to the extent repair expenses exceeded the claim assessment of the surveyor and reimbursed by the insurer to the owner of ESTEEM vehicle. The owner of Santro Vehicle did not prefer a claim with his insurers but claimed the repair expenses from Mr Ajay, the owner of EON vehicle. Mr Ajay reimbursed ₹5000/- to the owner of the Santro vehicle. Mr Ajay got the repair expenses of EON from FG insurance. Repair expenses to the ESTEEM vehicle were reimbursed partially by TAIG Insurance to the extent assessed by the surveyor and repair expenses over and above the surveyor's assessment was borne by Mr Ajay (₹10000/-) and similarly he had also paid ₹5000/- to the owner of Santro vehicle as stated above. Mr Ajay got his EON car repaired and wanted FG insurance. (i) To reimburse ₹10000/- the excess of repairers'bill over and above what had been admitted by TAIG Insurance. (ii) To reimburse ₹5000/- the amount of repair expenses paid to the santro owner. The policy issued by FG Insurance for EON car was comprehensive and showed TPPD of ₹750000/- and obtained premium for the same in addition to collecting OD premium for the car. Mr Ajay contended that it was not any compromise to the third party(ies) (owners of ESTEEM and Santro vehicles) but had reimbursed the excess of the repairer's bill over and above allowed by TAIG Insurance for ESTEEM and since Santro owner did not prefer a claim with the insurers. Please answer the following: Explore the possibility of FC Insurance repudiating/admitting the claim of ₹15000/- for reimbursement to the respective third parties for the property damage to their vehicles.
Answer & Explanation:
FG Insurance can repudiate the claim stating their inability to honour TPPD reimbursement settled by insured as the claims are required to be received through the competent authority. FG Insurance can also settle the claim as one time exception as ex-gratia after receiving a representation from the insured and getting a notarized affidavit from the concerned third party(ies) that their claims have been fully and finally settled by the insured and that they would not be staking any further claims in this regard. The competent authority to sanction such ex-gratia cases shall be Managing Director of insurance company. FG insurance should also satisfy themselves by getting the copy of the bank statement from the insured showing the debits with the respect to the payments made by third parties.
Topics: Motor Insurance
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