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Action Plan during an Event

The reaction of insured, his representatives/employees during an event is vital and should be in-line with the policy terms & condition. In panic during the event or right afterwards, the insured might end-up doing things which he was not supposed to do or doesn't take certain steps which were required by the carrier. This in turn may adversely affect the claim; may result in the claim settlement getting delayed or even repudiated.

Following steps can be taken in general during the occurrence of an insured event

  1. Attend to injuries & provide first aid/medical care.
  2. Inform authorities (police, fire force etc) as applicable.
  3. Try to control the event & salvage the damages.
  4. Inform the Insurer, your Broker and follow their instructions.
  5. Try to gather as much evidence possible of the event/damages.

DURING MOTOR VEHICLES ACCIDENT

Own Damage Claims:
  • Immediately attend to personal injuries and hospitalization eventualities, if any.
  • Inform the Police
  • Note down the particulars of the other vehicles if there is any, involved in the accident
  • Intimate the Insurance Company/broker and get the necessary claim forms
  • Fill up the claim forms and submit the same, duly signed to the Insurance company along with the following documents:
  1. Registration Book of the vehicle
  2. Driving License of the person driving the vehicle at the time of accident
  3. First Information Report (FIR) from police authorities where warranted. FIR should reflect all damages.
  4. Details of the extent of damages to the vehicle (inline with FIR) and if possible, a quotation from the repairers
  5. On receiving the above documents the Insurance Company will arrange for survey, etc. and issue authorization  for repairs. After repairs, inform the  company for arranging resurvey. Finally, if it is not a cash less settlement, submit the bills to the company for settlement. 
Please remember:
  • To  keep a copy of the driving license of the driver. Some times, he may not be readily available after the accident.
  • To  keep the salvage safe in case of Total Loss , until your claim is settled.
  • To understand how the surveyor and the repairer have agreed on your claim.
  • To obtain  FIR and  post mortem reports in case of the death of driver/cleaner/workmen
  • To forward any notice from Third Party / Motor Accidents Claims Tribunal / court of law or any summons received to the insurance company.
  • Not to hand over your vehicle to some one who do not  have a valid driving license.
  • Not to repair / dismantle the vehicle before the inspection by the Company or the surveyor.

DURING MEDICAL EMERGENCIES

Notice of Claim must be given to the company within 7 days of hospitalization. Final bills and certificates along with the duly filled in and signed claim form  must be submitted to the company within 30 days of discharge from the hospital. following documents needs to be submitted to the insurance company in case of claim
  1. Bills, receipts and Discharge Certificate
  2. Bills, receipts of pathological tests and tests reports along with the prescription
  3. Bills and receipts for X-ray and diagnostic materials along with the prescription
  4. Surgeon’s bills and receipts
  5. Bills and receipts for medicines and drugs purchased from outside chemists along with prescriptions
  6. Certificate from the Attending Doctors stating that the patient is completely cured.


Expenses incurred 30 days prior to hospitalization on consultation, medicines, tests, etc for the same illness for which hospitalization is done and up to 60 days after discharge can be claimed under mediclaim policies.

DURING FIRE ACCIDENT

  1. Inform  immediately the Fire Force and take all possible  steps to contain the fire  and minimize  the loss.
  2. Inform the insurance Company/broker and follow their instructions.
  3. Documents that needs to submitted to the Insurance Company:
    • Duly  filled in and signed claim form along with the estimate of the loss and photographs.
    • Police FIR  and  Fire Force Report.
    • All the relevant books of account to prove and support  the claim
    • Original bills  and receipts of  Repair or  Replacement 

DAMAGE OR LOSS DURING CARGO TRANSIT

Documents required
  • Duly filled in and  signed Claim Form
  • Original Policy
  • Short Landing Certificate or Damage Certificate, open delivery certificate in case of inland road transit
  • Invoice
  • Packing  List, bill of entry
  • Survey report
  • Claim Notices served with postal acknowledgements and copies of  all the relevant correspondences
  • Letter of Subrogation and special Power of Attorney

IN THE EVENT OF BURGLARY

Documents required
  • Duly  filled in and signed Claim Form
  • Estimate of loss with necessary supporting documents and photographs
  • First Information Report from the Police
  • Final Investigation Report from the Police