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[Resolved]  Bajaj Allianz — arbitrary rejection of accidental claim by m/s. bajaj allianz general insurance

Reference : insurance policy no og[protected]-[protected]Bajaj allianz) & claim no oc[protected]-00013154/ arvind prasad singh/ 69733826/ for my car registration no :- wb 02 ad 0658.
Complaint registeration number : dpg/i/2018/80078 dated 21/01/2018

Respected sir,
With deep sense of anguish and frustration i solicit your kind intervention and help on priority to get my insurance issue resolved enabling me to get justice for being a law abiding citizen and an honest tax payer in all the spheres of legitimate statutory taxation obligations.
I have been running from pillar to post for almost last three months to get my accident claim approved which is not only legitimate and genuine but also within the parameters of insurance norms. There has been an accident which was very well recorded and established by the local police and in order to reiterate the facts i am just enumerating the summary of the event for your kind perusal as below :
1. My car model hyundai i10 (No :-wb-02-ad-0658) had met with an accident on dated 30/10/2017 at 3.30 pm at ningha (Asansol, west bengal.
2.. After completing the legal formalities i immediately contacted with insurance company (Bajaj allianz) to lodge my claim and my claim was registered on 7/11/2017.
3. Unfortunately despite several reminder to the insurance company bajaj allianz, did not take any action to resolve and r approve the repair cost so that i can go ahead with the repair job.
4. It is almost more than 120 days that my car is in breakdown condition and lying unattended in the show room of m/s. Rudra hyundai, 223, ushagram, g. T road (Asansol) since date 03/11/2017

5. I wish to furnish a synopsis of the events for your kind perusal :

A) all the documents were submitted such as blue book, police general diary, police paper report at the time of claim on 7 oct 2017 to the insurance company.

B) even after 21 days did not receive any response.

C) i was compelled to escalate the claim to ggro & head customer service/ho-direct marketing/customer care/general on 28/11/2017. Despite escalation no resolution.

D) out of sheer depression and frustration seeked the intervention of pmo.

E) despite the intervention of the honorable pmo, the insurance company instead of trying to resolve the issue repeated their objections through querries which are already clarified and replied.

F) finally, citing the reason “no cooperation” by the insurer rejected the claim.

The entire scenario enumerated above cleary establishes the biasedness and determination of the insurance company to victimise and harass a law abiding citizen and adopt the vendetta syndrome to satisfy their own large ego with the sole aim to harass, which has compelled me to approach the highest forum to seek justice.

I request to kndly intervene once again and appeal you to help me in getting justice by suitably advising the insurance company.

Thanking you,

Yours faithfully,

Pankaj kumar
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Mar 13, 2018
Complaint marked as Resolved 
Dear Sir, As discussed with you we had already given you the work order, not provide the cashless facility. The claim is under fact verification as discussed with you, it will take some time. After getting the report we will take the decision of cashless facility. Thanks & Regards Subhas Dutta | Kolkata Motor Claims| 033-6602-4860| [email protected] 3rd Floor, Block-B, Eco Space, Plot No: II/F/II, New Town, Rajarhat, Kolkata- 700156 From: Priorityhandle/Ho-Direct Marketing/Operations/General Sent: Wednesday, November 29, 2017 1:40 PM To: '[email protected]' Cc: Subhas Dutta/Kolkata/Claims Motor/General Subject: Reminder for Confirmation of CAR No WB 02 AD 0658 under insurance Policy OG-17-9906-1801-00088354/ claim status/ OC-18-2401-1801-00013154/ ARVIND PRASAD SINGH/ 69733826/ 29-11-17 Dear Mr. Singh, We acknowledge receipt of your grievance in respect to settlement under Claim number OC-18-2401-1801-00013154. We have registered your matter with us vide issue number 69733826. Kindly quote this reference number for all future correspondences. The captioned issue is being referred to Mr. Subhas to look into the matter once again and resolve. He is marked in the mail on his mail id. He will get in touch with you on your contact e mail / phone number provided below by you. We will request you to kindly let us know of the same, in case you do not get a response from him with 24 hours of receipt of this mail. Dear Mr. Subhas, We are forwarding herewith a claim query received from the customer. We request you to kindly go through the contents and have a word directly with the customer to resolve the issue. We request you to kindly update us on the issue when resolved. In case the time to resolve the query will take more than one day, then please let us know the probable date by which the matter will be resolved. Thanks & Regards, Kiran Bala, Priority Handling Desk Grievance Redressal Unit Bajaj Allianz General Insurance Company Limited. Contact from: Any Landline/Mobile: 1800-209-5858 MTNL/BSNL: 1800-22-5858 Bharati: 1800-102-5858 Others: 30305858 For further related queries or concerns mail us at [email protected] Thank you for reaching the Customer Focus Unit of Bajaj Allianz General Insurance Co. Ltd. It is our endeavor to serve you as quickly as possible. ________________________________________ From: Pankaj Kumar [mailto:[email protected]] Sent: Tuesday, November 28, 2017 4:03 PM To: Ggro Bagic Cc: Head Customerservice/Ho-Direct Marketing/Customer Care/General Subject: Reminder for Confirmation of CAR No WB 02 AD 0658 under insurance Policy OG-17-9906-1801-00088354 Dear Sir This is to inform you that My car Model Hyundai i10 (No :-WB-02-AD-0658 ) has met with an accident on dated 30/10/2017 at 3.30 PM at Ningha (Asansol, West Bengal) Due to this it has suffer Damages & the Car is kept at Garage Rudra Hyundai, 223, Ushagram, G.T Road (Asansol) from date 31/10/2017 but there has been no progress in repair Job Understand that necessary confirmation from your insurance company has not been given to the garage to start their work. In this regard I have already to registered my complaint vide No 69605345 on dated 21/10/2017 through Phone but unfortunately has to remind you again . All the necessary information like :- GD, blue book, ..etc has been already shared with you & also attached this mail Kindly do the needful at the earliest Further Any clarification please revert back Thanks & Regards Pankaj Kumar
Mar 09, 2018

Complaint Status

Bajaj Allianz customer support has been notified about the posted complaint.
Mar 13, 2018
Updated by panka82
Dear Mr. Roy

This is refers to your letter dated dated 28.12.2017 and 08.01.2018 with regards to your above mentioned claim and your letter dated 05.01.2018 & the emails exchanged.

Please find attached response

Clause 1:
Our claim is being backed by Police Report. The material facts of the case/claim are vividly stated in the said report. I simply fail to understand that from where you come to a conclusion that material facts have been suppressed. This is a serious allegation against me and I have taken offence against the same. Further, for a claim to be considered by your good office, do you think we would be that much reckless to have put forward incorrect documents and demand money. My vehicle has been damaged and it was sent to the garage, your surveyor visited and checked the vehicle and was fully satisfied with the inspection. Your present stance is an afterthought of which I have no explanation. I reiterate that my claim is genuine and legitimate and no part is being concealed or suppressed or misrepresented as alleged by you. This is a simple claim and you are making it complicated. Your allegations are false, vexations and misconceived.
Clause 2:
Please note that your concerned good office was intimated immediately, however the claim was lodged at a later date along with all relevant papers. Your person have seen both the vehicle as well as the spot. It seems that your good office was wrongly informed and owing to your office being short staffed your personnel could not corroborate the facts as desired and/or as alleged by you. This is not my fault. The law of the land does not preclude you to honor a claim or repudiate it on flimsy grounds.

I am a law abiding citizen of India and a honored tax payer. I work in a company of great repute in India and abroad. Hence, I request your good self to kindly consider my case and act accordingly so that natural justice is restored.

Thanks & Regards
Pankaj Kumar

From: Priorityhandle/Ho-Direct Marketing/Operations/General [mailto:[protected]]
Sent: Wednesday, March 7, 2018 5:16 PM
To: Pankaj Kumar
Cc: Suprava Roy/Ho Direct Marketing/Call Center/General
Subject: Prime Minister Office/ PMOPG/E/2018/0088621 / IRDAI Token no.[protected]/ OC[protected]-00013154/ PANKAJ KUMAR/ 71795426/ 7-Mar-2018

Dear Mr. Kumar,

This is with reference to your complaint in PMO office regarding clarification of claim repudiation under complaint no. PMOPG/E/2018/0007768 and DPG/I/2018/80078

Please find the attached Repudiation Letter dated 24th Jan 2018 sent by registered Speed Post under AWB no: RW[protected]IN.

We had informed by our claim team that they have spoken with you and explained the reason of repudiation.

Please find the attached email communication dated 4th Jan for your reference with clarification of your points.

By registered post

Mr. Arvind Prasad Singh Date: 24.01.2018
Flat No: 1K, Nature Nest
14, P.G.H.S. Road
West Bengal
M: [protected]

Ref: Claim No. OC[protected]-00013154
Policy No. OG[protected]-00088354
Vehicle No. WB02AD0658
Date of loss: 30-Oct-2017

Dear Sir,
This has a reference of our letter dated 28.12.2017 and 08.01.2018 with regards to your above mentioned claim and your letter dated 05.01.2018 & the emails exchanged, documents submitted by your good self and report of an independent IRDA licensed surveyor, we have observed following :-
1. As per the cause of loss in claim form the vehicle had impact with road divider; however as per physical inspection of the vehicle it is observed that there is no impact on the wheel or below the height of wheel rim. The damages neither correlate to cause of loss nor with the spot of accident shown later. There is misrepresentation of material facts and wrong declaration signed in claim form which states, I/we the above named, do hereby, to the best of my/our knowledge and belief, warrant the truth of the foregoing statements in every respect and agree that if have made any false or fraudulent statement of there be any suppression or concealment, the policy shall be cancelled and the claim shall be forfeited.

2. There is delay in intimating the loss to the police of 3 days and to the insurers for 7 days, hence no opportunity was given to verify material facts related to accident. As per policy condition no 1, ”Notice shall be given in writing to the company immediately upon the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require”.

Therefore, in view of the above, your claim stands repudiated. Also, please confirm us within 7 days from the date of receipt of this letter that why we should not cancel your policy.

Please note that nothing contained in this letter is or should be construed as a waiver of any one or more rights on our part and all our rights under and in relation to the policy remain fully reserved.

Thanks & Regards,
Suprava Roy
Priority Handling Desk,
Grievance Redressal Unit,
Bajaj Allianz General Insurance Co. Ltd.
Mar 24, 2018
Updated by panka82
Dear Sir

Till date my complaint has not resolve


pankaj kumar
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