Dear All,
Mr. Sanjeev Soni of Delhi is a chartered Accountant Surveyor and IRDAI issued an order by which he felt defamed and contested the case in higher court and got some directions to IRDA. He has given his side of explanation on his You Tube Channel also with videos.
The main issue of his case was that while assessing loss in a reinstatement policy, he was suppose to verify the bills submitted by the insured, which were found to be bogus. After reading and hearing of his case, I am prompted to share some of my thoughts and wish members to give thought and deliberate on the issues related to duties and responsibilities of the Surveyors as laid by IRDAI in her regulations.
I am of the opinion and hopefully all of you shall agree, that in a claim settlement there are two sides which insurers need to see before paying off. 1. TECHNICAL and 2. LEGAL.
1. Technical is to ascertain the cause of loss (to establish whether cause is covered in policy or not) and then loss attributed to the cause of loss. These two can be established by physical and technical inspection of site and also the damages. Obviously these have to be done by a technical experts to be precise the surveyor, who under law has to be licensed.
2. The legal aspect of a claim has to be ascertained by the facts that come to light from the surveyor's report with reference to the terms & conditions of the policy.
I feel that provision in the law giving final authority to the insurers to accept or reject the claim and Surveyor's report not a binding on them was because of this legal aspect which is to be ascertained by the insurers.
Now coming to Mr. Sanjeev Soni's case (There are few more that have propped recently) It is said or expected of surveyor to verify the bills of repair submitted by insured. Question arise - is bill verification any way a technical point or a legal point. Question also arise that what is the limit of verification. Verification can be that the bill issue by a real seller (or a labour service provider) or even to verify further that bill by the seller is issued genuine. Thus there is no end to verification.
In a similar situation of a Motor claims if the workshop where the vehicle is repaired issues a fabricated bill and does not bring in his records, can a surveyor be alleged of failing his duty.
IRDAI Regulation on Surveyor's Duties- On going through the surveyor's duties, it is desired that surveyor should give his remark even on admissibility of the claim as per terms of policy. I do not agree to this duty of surveyor as the claim admissibility is finally decided after satisfying the legal aspects of the claim.
Thus I feel that Duties and Responsibilities of surveyor should be redefined which can be done by IIISLA Council taking up with IRDAI through IAC and Surveyor Advisory Committee. But before that IIISLA should deliberate on the issue.
In view of the above, I propose that Delhi Chapter of IIISLA may hold a seminar cum conclave (Other Zones and Chapters may also hold similar meets) and deliberate on the issue. A White paper may be prepared on the discussions and proposals and put before IRDAI through IIISLA Council. This issue is common for all surveyors be it motor or non motor, independent or corporate and therefore all should take up this issue together.
I wish members shall come forward to deliberate the issue to better and improvised working of profession.
C K BHATIA
09810231248