[Resolved]  NATMAR Insurance — Claim non-settlement and unethical practices

Category : Vehicle Insurance

Complaint Summary
===============

I would like a redressal of the following
1. An immediate settlement of my accident case as a comprehensive total loss with the settlement amount equal to the IDV for which the premium was charged from me and which has been pending for more than 5 months now.
2. Claim for the missing part as covered under theft in my already active insurance policy.
3. Proceedings against the insurance company to open up the policy document for the previous 5 years to ensure that I have not been overcharged as the insurance company is itself saying so right now.
Complaint Description

Details regarding the case:
=================

* Vehicle registration number: HR 26P 6287
* Vehicle type: Zen Lxi
* Vehicle model: 2002
* NATMAR policy No : 3489972
* IDV: INR 144, 000

The case of my car accident which has been long pending due to inaction on the part of the National Insurance Co. to clear my dues.

I had met an accident on 21st June 2008 and the case was reported to PASCO automobiles, Gurgaon. The surveyor assigned to my case is Mr. Avnish Kumar (+91-[protected]). The survey was completed within a week to 10 days and the estimate charges for the vehicle repair value provided by PASCO were close to INR 2.4 Lacs.

A scanned copy of the estimate provided by PASCO(authorized Maruti dealer) has been attached herewith .

As per the policy norms, it was suggested by PASCO after their engineers had inspected the car, that it is better to get the vehicle cleared under Constructive Total Loss (CTL). This is as per the Section I, Article 4 of the Insurance policy document provided to me by PASCO automobiles whereby " The insured vehicle will be treated as CTL if the aggregate cost of the retrieval and/or repair of the vehicle, subject to terms and condition of the policy, exceeds 75% of the IDV value".

The PASCO engineer told me that the chassis is broken as well as bent and even if repair is done, the car will never be able to perform as an undamaged car.

The IDV of the car is INR 144, 000 and a CTL can be declared if the repair costs are more than INR 108000 as per the policy document.

Actions taken for claim settlement
======================

I had requested my vehicle to be declared a TCL just 2 weeks after the accident. However the matter is still hanging unresolved.
I had escalated the issue to Mr. Deepak Kakkar from Maruti Insurance, but unfortunately he has not been able to help me or explain satisfactorily the reason for the delay in the insurance payout.
Mr. Deepak told me that there is one Mr. Gandhi[protected] from the National Insurance who is handling this case who is not ready to accept the case as a CTL due to unknown reasons.
The delay in the insurance payout has already caused a lot of pain.

I already have had 4 meetings in person with the insurance surveyor and numerous emails and phone calls have the following inputs from the insurance surveyor over my 4 meeting with him spreading over the last 4 months. The latest meeting held on 01st October 2008.

1. The insurance company has asked me to accept a settlement of INR 120, 000 for the total loss (initially they were ready to give only Rs 90, 000, after my continued perusal the amount has been increased to the current value). This is still contrary to the IDV of 144, 000.
2. I am not clear why the estimates from PASCO Automobiles, an authorized Maruti dealer are not being considered genuine. Does this mean that PASCO automobiles have a reputation of fleecing customers with high repair bills? My conversation with the insurance company at least suggests that.
3. I was told that the liability of the insurance company is less and hence the insurance company is not agreeing to pay the total amount. However, this was never satisfactorily explained.
4. The surveyor, Mr. Avnish Kumar said that the insurance company would rather give me a replacement vehicle of the same model and make rather than giving the total loss. This was very surprising to me.
5. A consent letter has been provided to me for signing for the mutual agreement and I am being asked to sign it to make the things move forward even when there has been no mutual agreement.

I had decided that purely in the interest of time I will settle for a little less and make sure that the claim is close to the earliest as it had already been 4 months since the claim was filed. The insurance company told me that they would put a value to the damaged card and send a buyer for that. However when the buyer came he told me that a part (ecm ?) was missing from the vehicle and hence he would not pay for that. I think that the insurance policy is still active and any theft should also be covered. The vehicle was at the accident site for more than 4 hours before being towed away by the crane. Then it was in PASCO automobiles for over 40 days. I believe that the part could have been missed either at the accident site or during the parking stay in PASCO hence I would not be the right person to be made accountable for that.

On talking to the insurance company (Mr Gandhi, +91-[protected]), he advised me the following. He said that the missing part (ecm?) has a current market value of Rs 12000. However the buyer of the scrap car will reduce the buy amount by Rs 5000 and NOT the deprecated value of the part. As per my understanding the value that should be deducted from the claim is the deprecated value of the part, after 6 years of deprecation and not the new value. The same was explained to me by Mr. Sudhir Pal, from NATMAR INSURANCE.

Also, one aspect which was very disturbing was that after talking to me for over 4 months about the claim, Mr. Gandhi from the insurance company told that their office has nothing to do with the claim and I should be contacting the Gurgaon office. I am really saddened by this apathy shown in settling the claim.

Latest conversation with insurance company representative
=======================================

The latest stand that the insurance company has taken is that the IDV that is written in my policy document and for which the premium was charged is HIGHER than the market value of the car! They say that the IDV should have been less. This is really absurd as I have already been charged the premium for that and the insurance company is liable to pay the value as agreed between us on the policy document.

This has also made me believe that I have been taking the services of the National Insurance Company since the last 6 years, I am sure that I must have been overcharged in the premium. I would like to open up the policy document of the previous 5 years as well to ensure that I have not been fleeced by the Insurance company by providing me a bogus IDV and charging a higher premium.

Complaint Summary
=============

I would like a redressal of the following

1. An immediate settlement of my accident case as a comprehensive total loss with the settlement amount equal to the IDV for which the premium was charged from me and which has been pending for more than 5 months now.
2. Claim for the missing part as covered under theft in my already active insurance policy.
3. Proceedings against the insurance company to open up the policy document for the previous 5 years to ensure that I have not been overcharged as the insurance company is itself saying so right now.