Non settlement of claim by IFFCO TOKIO General Insurance Co.( Policy No. 74658751)

Dear fellow,
Please help/guide me.

It is brought to your kind notice that undersigned met with an accident of his  Maruti Zen car No. HR-51K 5961 at Mathura road Faridabad in the evening of 18^th December 2010  The car was insured with Iffco  Tokio General Insurance Company Ltd ( Insurer) with policy No. 74658751. Insurer was immediately informed about the accident. As per instruction of the insurer, car was shifted to the workshop of M/S Batra Auto Company (Repairer), Mathura Road Faridabad along with  claim form and  other documents required for claim processing on 22/12/2010. The repairer prepared the  estimate No. 35254 dated 24/12/2010 of the order of Rs2,50,000/- (Rs two lakh fifty thousand  approx)& submitted to insurer with a copy to me for further n.a.  

Insurer appointed a local Senior Surveyor to assess the Loss.

I was pursuing the settlement of claim thr the insurer’s agent shri Shailender Kumar ( Ag. No. 27000115) for the settlement. Inspite of his best efforts , I have heard nothing from the insurer about any development for claim settlement till February 22, 2011 when I lodged a complaint on insurers website for my grievance for non settlement of  claim. The insurer repied on 24^th Feb 2010 about the registration of my complaint with complaint No. 1-1028398250 and quoting a false  message that ‘ You were unhappy with insurer not
issued claim cheque in spite of offer of settlemet’ in spite of the fact that I was neither informed by any agency  viz insurer, SLA or agent nor issued any offer of settlement  till then. It was also conveyed to me to communicate in future with  their grievance officer Shri P.J. pradhan via email or phone quoting the complaint No. in all future communications. I have replied this email message same day saying that  no offer of settlement is issued to me till date and requesting to look into the issue of my claim settlement as per rule/policy at the earliest possible.

On 9^th March 2011 I received SMS  as well as email message with regret that complaint No. 1-1028398250 being investigated is likely to take more time.

On 11^th March 2011, I received a SMS that ‘your complaint is resolved and letter confirming same is being sent’ which is not received till 16^th of March 2011  and therefore, the insurer via email on 16/03/2011 was requested to examine and expedite the issue of claim settlement forwarding  a copy to IRDA for  information.

Insurer was also requested via email  on 18/03/2011 to look into to resolve the issue expeditiously. This message was also forwarded to IRDA on 19^th March under intimation to insurer.

I was embarrassed  &  felt harassed  getting no reply from the insurer, a letter of request) was emailed  to the insurer with a copy to IRDA on  23/03/2011 explaining my liabilities of making payments of Rs 5000/-to the repairer towards the preparation of estimate  and also to pay  parking charges@ Rs100/-per day   which is getting multiplied day by day and will be a loss to me due to delay in settlement. I also requested to the insurer to issue me a copy of survey report for my perusal and  record.

 In the evening of 23^rd March 2011, I received email  reply from the insurer which is self contradictory. On one hand it says that the surveyor assessed the loss on  repair basis and on the other hand  it says that company has not yet received the survey report. How the surveyor assessed the loss and how the insurer based his opinion and in fact lame to hide the inefficiency on their part and deficiency of services on the part of insurance company. I have replied this email message of the insurer on 29^th March 2011 quoting the obligations of insurer as per IRDA regulations and explaining that whole process of assessment of  car and preparation and submission of survey report by SLA should have been completed within two months and that the delay  in the process of claim settlement is on your part (Insurer). Insurer was also requested to send the offer of settlement along with a copy of survey report explaining  liabilities of insurer and insured separately.
Insurer replied via  email on 29^th March 2011 which is a bundle of lies. Insurer says that the DL and other required documents were not submitted in time. This is false and all documents were given at the time of putting the vehicle in repairer’s garage on 22/12/2010. If the documents were not submitted in time, insurer or surveyor never asked for documents either via email or letter. Whereas the same were submitted on 22/12/2010. Insurer has never informed about the developments taking place till 22^nd Feb 2011 till I lodged a grievance complaint on its website. Insurer has informed that the original documents got verified only on 20/02/2011 indicating the deficiency/deliberate delay  on the part of insurer.Insurer also tried to manipulate the  facts of its deficeiency/ malafide intentions as the screen  shot of the email from SLA to repairer and vice versa  is self explailnatory.

 I failed to understand, how the SLA arrived for tentative loss of Rs65,000/- against an estimated loss of the order of Rs2,50.000/-.

 Insurer was again requested to provide the copy of survey report. Insurer again refused the request vide email message dated 29/03/2011 violating IRDA regulations.

On 09/04/2011,Insurer was requested to appoint an another SLA for his independent opinion about the loss assessment. Insurer did not comment on this in his reply dated 14/04/2011.

Therefore, I have informed my disinterest to get the vehicle repaired as the condition of the vehicle further deteriorated for being unattended for a long time. Insurer was requested to retain the vehicle and settle the claim in light of repair estimate of the order of Rs2,50,000/-.

The point vise reply of the insurer was sent on 09/04/2011followed by reminder on 14/04/2011. The reply of the reminder received the same day informing that the surveyor has been instructed to conclude the claim since the vehicle is repairable The Surveyor did not contact me so far for discussion and seeking my advise on the issue.

It infers that there is connivance between insurer, SLA and repairer to harass the innocent customer without any fault of him  and pressurizing  the customer to agree to its terms  by creating false and  fabricated  conditions.

Complaint was also lodged with IRDA against iffco TOKIO. IRDA communicated vide email message dated 15/04/2011that the complaint No. is 04-11-000086 and forwarded to the insurer.

The insurer replied on 18/05/2011 vide email  that the surveyor has opined that the vehicle is repairable and does not come in the purview of total loss.

Your advice &  comments are invited for  conclusion for  logical solution of the above issue

As per my experience I would like to advise that the private insurance companies in general  and IFFCO TOKIO I in particular  are big cheaters which  try to yield the  customer to  to their unethical   terms and conditions.

You are requested pl. don,t edit it.

JP Jain

(jainjp@iocl.co.in)