What is Motor Vehicle Insurance?
Insurance is of two types: Life insurance and General insurance. Any insurance that is not life insurance is a general insurance. Motor Vehicle insurance is, therefore, a form of general insurance.
Motor vehicle insurance forms a major part of the insurance industry. A motor vehicle insurance policy covers two main things:
1. Damage to the person who holds the insurance policy that includes damage to his or her vehicle or property or body.
2. Damage to another person who has been injured because of the vehicle of the insurance policyholder.
Before proceeding further, it would be helpful to become familiar with commonly used terms related to motor vehicle insurance:
Third Party Cover: A third party cover means the protection that is given to the motor vehicle policyholder against any financial liability that may arise because of injury, damage or death of their party. (A third party is a person that is not a party to the insurance policy; parties to an insurance policy are the insurance company and the insurance policy holder). A third party cover ensures that if a third party files a claim for damages against the insurance policyholder, then the insurance company will compensate the third party on behalf of the policyholder.
The law provides that every person who owns a motor vehicle has to get a third party cover.
When a third party suffers loss at the hands of an insurance policyholder, they have to first obtain the policy holder’s vehicle details in order to make a Third Party Claim.
Own Damage Premium: Own damage premium is the premium paid by the vehicle insurance holder in order to be eligible to claim the insurance cover is the main part of the total amount of premium paid for motor insurance. Own Damage Premium is payable to cover the insurance policyholder against losses that arise from causes beyond the control of the policyholder like damage due to earthquakes and other natural disasters and also man-made disasters like fire. The Own Damage Premium is not a fixed amount and will differ as per the vehicle model, its cubic capacity, the place where it is used etc. In case a person wants to file an own damage claim upon a motor vehicle incident, they must inform the insurance agency as soon as possible and also inform the police.
The motor vehicle insurance is a unique form of insurance since it combines several other types of insurances. This means that a motor vehicle insurance policy may include indemnification against damages due to accidental external causes, fire, theft and acts of malice like riots. The motor vehicle insurance policy can also protect the policyholder against claims arising because of damage caused when the insured was driving a vehicle which did not belong to him or if some other person was driving the vehicle of the insured upon his permission or order.
A compulsory motor vehicle insurance (i.e. a third party insurance) covers only the losses arising to the third party and does not cover losses to property or person. On the other hand, a comprehensive insurance policy indemnifies not only the third party but also property and person.
Under what circumstances can motor vehicle insurance be claimed?
Motor vehicle insurance can be claimed for motor vehicle accidents arising out of the following incidents:
• Theft, burglary, housebreak;
• Fire, lightning, self-ignition, explosions;
• Strikes or riots;
• Acts of terrorism;
• Malicious acts;
• Floods, hurricanes, frost, hailstorms;
• Accidental external means;
• Damage while in transit by road, rail, air, inland waterways, elevator or lift.
Under what circumstances can motor vehicle insurance be not claimed?
A motor vehicle insurance claim can be denied under the following circumstances:
• Mechanical or electrical breakdown of the vehicle
• Accidents caused due to driving under the influence of alcohol or prohibited substances
• Driving without a proper driving license
• Accidents that take place outside the geographical jurisdiction of India
• Accidents that occur when the vehicle was being driven for unlawful purposes.
What are factors that determine the quantum of payment?
There are several factors that determine how much compensation is payable for a motor vehicle insurance claim. These factors include, but are not restricted to:
• The type of policy of the insured
• The premium paid on the policy
• Warranties and conditions in the policy
• Validity of the driving license and permits
• The type of vehicle driven
• Ownership of the vehicle
What should you do regarding insurance claim if you get into a motor vehicle accident?
• The first thing that should be done by the claimant is that he or she should immediately inform the insurance company.
• The vehicle should not be moved from the place where the accident occurred without obtaining prior permission from the police.
• Repairs to the vehicle or the property where the accident took place should not be done without obtaining prior permission from the police.
• The insurance company is responsible for paying the repair shop and if cashless services are available then the insurance company shall directly pay the workshop.
Procedure for applying for an insurance claim
Where can you apply for a claim?
Insurance claims for motor vehicle accidents are applied before the Motor Accidents Claims Tribunal (hereon called the Tribunal). The Tribunal is a body created under the Motor Vehicles Act, 1988 which was formed in order to speed up the process of claiming compensation for motor vehicle accidents. All insurance claims for motor vehicle accidents have to apply to the Tribunal and not the regular courts of law if that particular accident falls within the jurisdiction of the Tribunal. The number of members that sit in a Tribunal is different for each state as the state government is empowered to decide upon their number. A member of the Tribunal can be any of the following:
• High court judge
• District judge
• A person that is qualified enough to be appointed as a High Court or District Judge.
If one is not satisfied with the decision of the Claims Tribunal, then they can appeal to the High Court. An appeal should be filed within 90 days from the time when the Tribunal gives its decision. However, the High Court can take up the appeal even if it is filed beyond 90 days if the appellant is able to convince the court that the appeal was delayed because of legitimate reasons.
Which Claims Tribunal has jurisdiction?
The question of claims Tribunal upon which one can file the insurance claims application can be determined by either of the two conditions:
• The claims Tribunal which has jurisdiction over the area where the motor vehicle accident took place; or
• The claims Tribunal that has jurisdiction over the area where the defendant resides.
Who can apply for claims?
Following are the persons who can file a petition before the Tribunal for a motor vehicle insurance claim:
• The person who has been injured in the motor vehicle accident.
• The person who owns the property which has been damaged in the accident.
• The agent of the person who has been injured in the accident and who has been authorised by such an injured person to represent him.
• The legal representatives of the person who died in the motor vehicle incident.
• In a case where a person has died in a motor vehicle accident but his legal representatives have not joined in on the claims application, the application can be made by another person for the benefit or on behalf of the legal representatives. Moreover, such legal representative can also be impleaded as respondents to the application.
Contents of a Motor Accident claims application
Given below is a list of essential information that is required to be included in a motor accident claims petition before a tribunal. It should be noted that the below-mentioned information is some of the important information required by the Motor Accidents Claims Tribunal of Delhi and Tribunals of other cities might require some additional information. It is best to check with the Tribunal of the concerned city to know about what information is required.
• Name, address, age of the applicant.
• Time, date and place of the incident.
• The make and registration of the vehicle.
• The income tax paid by the claimant.
• Nature of injuries and period of treatment along with expenses for the same.
• The medical officers who treated the injured.
• Name and address of the driver, insurance company and owner of the vehicle.
• The amount of compensation that the applicant is claiming.
• In addition to this, the applicant may also include any other information that may be helpful in rightfully disposing of the case.
The insurance claim application should also accompany the following documents:
• If an FIR was registered for the accident, then a copy of the FIR should be attached to the application.
• In case of death, a copy of the Death Report or the Post Mortem Report or the MLC should be attached.
• Documents that establish the identity of the claimant or the deceased.
• If available, the documents which establish the educational qualifications of the deceased.
• Documents establishing the income of the injured person or the deceased.
• Documents establishing the age of the injured person or the deceased.
• The record of treatment of the injured along with the original copy of the medical bills.
• The Disability Certificate should also be attached if the injured person has already obtained the same,
• A cover note of the third party insurance policy.
• In addition to these documents, an affidavit should also be produced which supports the abovementioned documents. In case where the motor vehicle accident resulted in a death, then the affidavit should also provide information about the relationship between the deceased with the claimants.
What is the period of limitation?
The insurance claim application should be made within a period of six months from the date of when the motor vehicle accident occurred. However, the tribunal can still accept insurance claim petitions after the expiry of six months but before twelve months if the claimant can satisfy the tribunal that the delay in filing the application for the tribunal was for a legitimate cause.
When a motor vehicle accident is reported to the police which involves either an injury to the body or death of a person then, as per Section 158(6) of the Motor Vehicles Act, 1988, the officer in charge of the police station will send a copy of the report to the Claims Tribunal that has jurisdiction over the case within thirty days from the date the accident report is recorded by the police. The police may also send a copy of the same to the concerned insurance agency.
Where a copy is made available to the owner, the owner shall also within thirty days of receipt of such report, forward the same to the claims Tribunal and his insurer.
Insurance can be claimed in case of thefts
An insurance policyholder can apply for an insurance claim if their vehicle gets stolen. In order to do so, the following are some helpful pointers which helpful in case a theft happens:
• The first thing to be done is to immediately inform the insurance company and the police about the theft.
• The transport department also has to be notified of the theft.
• It is prudent to read through the insurance policy documents beforehand and be familiar with the policy contents. This will be useful as it would make the policyholder more familiar with the procedure of insurance claim so that last minute hassles are avoided when the need to make a claim arises.
• When a claim is made, the claimant should submit all the required documents with the insurance form.
• Sometimes, there are specific requirements with a different insurance policy. For example, a policy may require that the vehicle keys be surrendered. The claimant should read the policy document at the time he or she receives it in order to be familiar with such nuances.