[Resolved]  Bajaj Allianz — Partial settlement of motor vehicle claims

Address:

600106

From 31.10.2016
Insured:
Basil miranda, s/o. michael miranda,
Residing at flat no.1 plot no.1123, g-block,
1st street, anna nagar, chennai 600 040

To
Insurer:
M/s. bajaj allianz general insurance co., ltd.,
Represented by its manager
Office nos. 276 & 277 n. nos.497 & 498
5th floor, poonamallee high road,
Isana kattima buildings,
Chennai 600 106
Tel: 044 – 4390440

Madam,

Sub: reminder to my earlier complaint forwarded through my lawyer on 26.10.2016 via e-mail and you have acknowledged the
Receipt of the same – regarding.
—

1. i have insured a motor car bearing registration no. tn02 ak 8224 of ford ikon 1.3 sohc flair model since my purchase on january 2011 and i annually renewed the policy insured under the private car package certificate – cum – policy schedule no. fba/[protected] for the period ending 11.01.2015 and the policy has been renewed for the current year 2016 vide certificate cum policy no. fba/[protected] on 08.01.2016 and the policy is in force.

2. i have paid premium of rs.4, 569/- for the year 2015 and a sum of rs.7, 846/- for the current year 2016 towards total own damage premium (a) apart from total liability covered under the package premium policy. i also paid premium of rs.9, 231/- under the head on own damage (a) i. e., vehicle and non-electrical accessories for the year 2015 and rs.8, 713/- for the year 2016.

3. my vehicle which is fully covered under the above valid insurance policies met with an accident on 02.12.2015 and the days following at flat no.1, plot no.1123, g-block, 1st street, anna nagar, chennai 40 and sustained damages on own fault. subsequently the vehicle was also damaged at koyambedu private bus operators stand where the front side left tyre got cut and the vehicle was made to stand in the incessant rainfall for 24 hours there itself. the said accidents were reported to insurer on 07.12.2015 through my car dealer m/s. chennai ford, arumbakkam, chennai. due to heavy rainfall and floods at chennai, due to the cessation of communication system there was a delay of 5 days to inform the insurer reporting damages caused to the vehicle.

4 (a) my vehicle also met with an another accident on 08.08.2016 at thana street, purasawakkam, chennai on own fault and raised claim on 10.08.2016 for replacement of front bumper and connected non-electrical parts and for damages caused to rear side left door and left side quarter panel. the surveyor surveyed the damages and he has approved only a sum of rs.8, 900/-, while the cost of the parts (bumper and other spares) against the actual cost works out to rs.12, 027/- (including taxes) and cost of labour rs.7, 401/- the total working out to rs.19, 428/-. if 50% depreciation for the parts is allowed the insurer have to indemnify a damages to a sum of rs.6, 000/- towards spare parts and rs.7, 401/- for the cost of labour which works out to rs.13, 401/- against the approved sum of rs.8, 900/-. thus a sum of rs.4, 501/- has been short approved by the surveyor.
(b) further the damages caused on the left back door was assessed to be rs.8, 465/- by m/s. chennai ford, poonamallee has not been approvedr. therefore i have been put to suffer monetary loss. hence there is short approval of rs.12, 966/- (rs.4, 501/- + rs.8, 465/-) by the surveyor which they are bound to indemnify the loss.

5 (a) the body shop work estimates for the claims made on 07.12.2015 works out to rs.50, 000/- before tax as per the estimation letter dated 03.09.2016 by m/s. chennai ford, poonamallee.
(b) as per the insurer’s letter dated 24.08.2016 addressed to me indicated that the preliminary assessed liability by the surveyor was works out to rs.8, 900/- which pertains to 2nd accident on 08.08.2016 and the insurer did not pay any attention to other damages claimed on 07.12.2015 which they termed it as old and accumulated in nature, though the insurer have settled the partial claim of approving ie., self-motor alone and palpably ignored the claims regarding body shop works and the cut tyre which was pending for more than 8 months with the insurer. it is pertinent to point out at this juncture that the surveyor has deliberately uncared for the assessment of other damages at the relevant point of time and the surveyor has chosen to report the damage to self motor among other damages and the claim was approved partially. i am entitled to claim damages under the cover of own damages as per the terms of policy certificate issued by the insurer.

6. as per the e-mail correspondence sent by the surveyor mr. naveen kumar on 29.09.2016 at 12.04 p. m. it is found that a sum of rs.8, 900/- (less tds) has been recommended by the surveyor and the claim is processed for rs.8, 900, only after re-inspection of the entire body shop work being done on 26.09.2016 and that too after an inordinate delay of 50 days and i have been put to suffer and made to incur monetary loss due to the said abnormal delay caused by the insurer in settling the claims thus it clearly tantamount to deficiency in service on the part of the insurer.

7. my legitimate claims regarding the own damage has been consciously delayed in survey of vehicle; then belated approval of claims; and then overlooking the other legitimate claims, which clearly amounts to deficiency in service for not allowing the claim of rs.63, 545/- (including taxes) towards damages for body shop works claims made on 7.12.2015 and rs.12, 966/- towards body shop work claims made on 08.08.2016, the claims raised on 10.08.2016, which totally works out to rs.76, 545/-.

8. i have been forced to settle the bill amount to chennai ford though the insurer have agreed to indemnify the damages failed to honour terms of policy contract.in view of the breach of agreement made in policy terms the insurer are also liable to pay compensation for deficiency in service in disregarding the legitimate claims and for the causing mental agony suffered by making numerous representations dated 10.08.2016, 22.08.2016, 15.09.2016, 19.09.2016 and 21.09.2016 and i quantify the compensation amount to sum of rs.1, 60, 000/- for the same since my vehicle was hiddling for 80 days (23 days) in december 2015 and (57 days) from 10.08.2016 to 05.10.2016.

9. my legal notice through my lawyer dated 17.10.2016 sent on 18.10.2016 by speed post with ack due which was received by the insurer on 19.10.2016 and it is not evoked with any response. therefore i prefer a complaint to your goodself on 26.10.2016 and you have ensured redressal at your end within 48 years, either i or my advocate is responded to the complaint. therefore this reminder is issued for disposal of my complaint.

I hereby request you to instruct the insurer to reimburse the sum of rs.76, 545/- paid to m/s. chennai ford, poonamallee vide their invoice no. rripg03427bl, dated 05.10.2016 to me together with the cost of estimated to rs.5, 500/- and rs.2, 500 towards the cost of horn and further pay a sum of rs.1, 60, 000/- towards compensation for deficiency in service as mentioned above immediately. basil miranda
List of documents
S. no. date description of documents
1 08.01.2015 car package policy certificate – cum – policy schedule no. fba/[protected]
2 08.01.2016 car package policy certificate – cum – policy schedule no. fba/[protected]
3 10.08.2016 claim for accident on 07.12.2015 and 08.08.2016
4 22.08.2016 follow up letter addressed to insurer informing partial approval by surveyor
5 24.08.2016 insurer’s reply stating the liability assessed only rs.8, 900/-
6 29.08.2016 letter addressed to m/s. chennai ford enclosing cheque for rs.13, 000/- demanding to carry out repairs
7 08.09.2016 letter from insurer addressed to insured informing to comply within 7 days
8 10.09.2016 letter addressed to insurer to settle the entire claims
9 19.09.2016 informing insurer that vehicle will be ready on 19.09.2016 demanding to settle the claims
10 21.09.2016 informing insurer that a sum of rs.64, 993/- has got to be paid to m/s. chennai ford
11 23.09.2016 insurer informed insured that only a partial sum of rs.9, 900/- will be paid
12 29.09.2016 e-mail correspondence of naveen kumar, service engineer, motor claims of the insurer that claim is processed to only rs.8, 900/- as recommended by surveyor
13 30.09.2016 invoice of m/s. chennai ford, poonamallee for sum of rs.76, 545/-
14 17.10.2016 legal notice to insurer claiming rs.76, 545/- and damages claiming deficiency in service/disregarding legitimate claims/causing mental agony by making numerous representations to the tune of rs.1, 60, 000/-
15 26.10.2016 e-mail complaint to your goodself id:[protected]@bajajallianz.co.in
16 26.10.2016 e-mail acknowledgment
Place: chennai
Dated : 31.10.2016 basil miranda