Insurance Ombudsman directs Bajaj Allianz to pay full value of Motor Insurance Claim

In The Matter of
Mr. Muneshkumar T. Maheshwari
Bajaj Allianz General Insc Co. Ltd.

Complaint No. AHD-G-005-1617-094
Insurance Ombudsman Date of award: 28.06.2016
Policy No: OG-16-2234-1801-00000806

Private Car Package Policy

The Complainant had purchased a “Private Car Package Policy” from Bajaj Allianz General Insc Co. Ltd. The Complainant was driving the said vehicle at Somnath Veraval highway on 26.11.2015. The vehicle met with an accident with motorcycle carrying three person. He had incurred an expense of Rs.67,627/- out of which the Respondent had approved to pay Rs. 60,738/-. His demanded the Company for payment of Rs.67,627/-. The Respondent had stated that as per the Surveyor’s report and the policy terms and conditions the claim was approved.

The policy was taken as Private car package Policy from 2013 for the first time and the claim had arisen for front bumper. The claim was for Rs. 67,627/- out of which the Respondent had approved Rs.60,738/-. The balance amount deducted was towards front bumper repairing cost. It is clear from perusal of the policy terms and conditions that coverage opted clause No,13 reads as under “pre existing damages in the vehicle: CRACK ON FRONT BUMPER.”

More over the front bumper was damaged beyond repair due to the accident. The cost of bumper can not be denied just because it had a few cracks. In view of the terms and conditions of the policy, the deductions made by the Respondent towards front bumper cost has no merits. The claim deserves to be settled after deduction of Rs:1000/- on account of compulsory excess and Rs:1000/- on account of additional excess.

The Forum, directs the Respondent to settle the claim at Rs. 65,627/-.