Re: Two Important Clauses in Motor Policies.

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ishwar singh jhinga

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Sep 2, 2013, 12:54:24 PM9/2/13
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Dear  Nearaj Ji
  The consequential loss is very well defined by Respected Sh Banargee.
Means  extra loss  occurred of insured due to accident  except the insured vehicle/ property .
 For example loss of his or his belonging members valuable due to this accident, loss of expenses spent by insured to watch the accidental vehicle, expenses suffered by insured to stay at spot/ hotel charges , diet charges, expenses suffered by insured in traveling here and there and mental fatigue sustained  because of this accident etc. The loss in your case in my opinion  is aggravation  of loss and not consequential

Thanks
Warm Regards,


Ishwar Singh
Surveyor
9811213418


From: Niraj Bansal <nirajba...@gmail.com>
To: "insurance-su...@googlegroups.com" <insurance-su...@googlegroups.com>
Cc: insurance...@googlegroups.com
Sent: Monday, 2 September 2013 9:13 AM
Subject: Re: Two Important Clauses in Motor Policies.

Dear Surveyors,

Can anyone define about CONSEQUENTIAL LOSS.

Thanks,
NIRAJ KUMAR BANSAL
SLA - 33405
KOTA ( RAJ. )
+919414187262


On Sat, Aug 31, 2013 at 6:23 PM, Binu Varkey <binu.s...@gmail.com> wrote:
Dear Surveyor,
  Please post your valuable opinion on the following clauses in Motor Policy.
 
1.In General Exceptions
A.Any accident loss or damage to any property whatsoever or any loss or expense whatsoever resulting or arising there from or any consequential loss.
 
2.     In Conditions
A.The Insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured.
B.In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are affected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.
 
Regards
 
Binu Varkey
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nitin katyal

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Sep 2, 2013, 1:36:11 AM9/2/13
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Consequential Loss Case study

The Insured was involved in a collision on 12th October 2001. Damage was done to the left and front sides of his vehicle as well as to the engine. The Insured was concerned about mechanical damage to the engine, but the Insurer insisted in having the repairs done at a workshop of its choice and an Assessor of its choice to verify the work.

He collected his vehicle on 16th November 2001 and whilst driving the vehicle from the panel beaters to his house, the vehicle started to shudder and he then noticed a red warning light, which had come on. He had first thought that it was the handbrake light. Because of the fact that it was raining heavily he decided to stop at the first garage, but before he could get to this turn-off, smoke came out of the engine hood. He then stopped.

The Insurer refused to pay for additional repairs on the basis that the Policy does not compensate for consequential loss. The argument was also advanced that the cracked cylinder head could have been avoided had the Insured stopped when the warning light came on.

After one letter to the Insurer it tendered to pay two-thirds of the repair costs. The repair costs amounted to R50,719.49. The Insurer tendered to pay R36,032.87.

Source: Ombudsman Newsletter : 02/03

Consequential Loss Consequential Loss

At 02h00 on 2nd September 2001 an Attorney’s ex-wife was traveling alone in Lois Street, Menlyn, Pretoria, when she was blinded by the bright lights of an approaching vehicle. At too late a stage she saw a speed bump and drove over it faster than she would otherwise have done. Nothing seemed wrong with the car, and she drove on. Approximately 1,5 Kms. further a warning light came on and she then drove to the nearest garage, which was about 1 Km. further on. It was discovered that there was serious engine damage due to the loss of oil.

Reason advanced for repudiation

The Insurer rejected the claim as the Policy contained an exclusion that there is no liability for Consequential Loss.

Ombudsman’s response

It was pointed out that the damage to the vehicle’s engine was not consequential and that the proximate cause of the damage was an insured event. Under threat of a ruling, the Insurer admitted the Insured’s claim.

Source: Ombudsman Newsletter : 03/03

Misunderstanding of the Misunderstanding of the consequential loss exclusion on consequential loss exclusion on the motor policy the motor policy

The insured was travelling east on the N4 from Witbank. Near a filling station at Machadodorp he saw that the temperature on his Mazda Etude was very high, and switched off the engine. Upon inspection, he found that it had been damaged by a bolt that had emanated from a truck, gone through the grill and damaged the radiator and air conditioner. He immediately called the towing services and his car was towed to Nelspruit. The insurer admitted liability for replacement of the radiator, shroud, grill and condensor as well as associated labour and coolant. However, it denied liability for mechanical damage to the engine contending that it was consequential loss.

The damage to the engine is not a consequential loss as contemplated by the policy. The vehicle sustained ‘loss or damage’ as a result of an accidental occurrence and therefore all the damage is recoverable. The only point of enquiry would have been the actions of the insured in minimising the damage, who stopped his vehicle as soon as he noticed the high reading on the temperature gauge. The insurer conceded and settled the claim in full.

Source: Ombudsman Newsletter : 04/04

What is consequential loss in What is consequential loss in terms of a Motor policy? terms of a Motor policy?

Situation On 10th March 2004, the Insured's almost brand new Toyota Hi-Lux (it had travelled 4,500 kills) in slippery and wet conditions fell onto its side. Passers-by pushed the vehicle back onto its wheels. Damage to the body was minimal. The Insured drove the vehicle to the nearest panel beater, which was about 15 kills away. After panel beating repairs, the vehicle was taken to Pretoria North Toyota where it was found that when the vehicle rolled on its side, oil from the sump leaked onto the piston, which resulted in excessive compression and which led to the bending of the con rods when the engine was started. The Insurer then rejected liability for the engine repairs on the ground that the Insured's negligence had caused damage to the engine.

Ombudsman’s response

The Ombudsman pointed out to the Insurer that the purpose of a Short-Term Insurance Policy is to indemnify the Insured against his own negligence. It was not unreasonable for the Insured to have assumed that after the vehicle fell over onto its side, that the vehicle had sustained no further damage. The Insured did not observe any lights on the dashboard to warn him of potential damage to the engine. The Consequential Loss Exclusion relied on by the Insurer was not applicable and is more relevant to financial losses and not to resultant damage sustained in an accident.

Source: Ombudsman Annual Report 2004

Misunderstanding of the Misunderstanding of the consequent loss exclusion on the consequent loss exclusion on the Motor Policy Motor Policy

Situation The Insured was travelling east on the N4 from Witbank and near a filling station at Machadodorp he saw that the temperature on his Mazda Etude was very high, and he then switched off the engine. Upon inspection of the engine, he found that it had been damaged by a bolt that had emanated from a truck and which had gone through the grill and damaged the radiator and air conditioner. He immediately called the towing services and his car was towed to Nelspruit. The Insurer admitted liability for replacement of the radiator, shroud, grill and condenser as well as associated labour and coolant. It denied liability for mechanical damage to the engine contending that it was consequential loss.

Ombudsman's response The damage to the engine is not a consequential loss as contemplated by the Policy. The vehicle sustained "loss or damage" as a result of an accidental occurrence and therefore all the damage is recoverable. The only point of enquiry would have been the actions of the Insured in minimising the damage, who stopped his vehicle as soon as he noticed the high reading on the temperature gauge. The Insurer conceded and settled the claim in full.

Source: Ombudsman Annual Report 2004

Cause of damage specifically Cause of damage specifically excluded situation excluded situation

On Saturday afternoon the insured was travelling along Rossini Boulevard, a dual carriage way in Vanderbijlpark. Because of a heavy downpour there was water across the road. The insured, traveling in a two-year old BMW thought that the water was not deep and proceeded through it, but the water turned out to be deeper than expected and the engine eventually cut out. One of the residents of Rossini Boulevard used his Bakkie to pull the BMW out of the water. The engine was damaged, the cost of repairs amounted to R9,527.39. The insurer rejected liability on the ground that the policy exceptions, inter alia, stated - "We will not be liable for damage to the engine or tyres unless some other part of the vehicle is damaged at the same time".

Ombudsman’s response

The Ombudsman agreed with the insurer that based on the facts, there was no cover in terms of the policy. Nitin katyal, delhi

Subject: Re: Two Important Clauses in Motor Policies.
Sent: Mon, Sep 2, 2013 5:14:45 AM

Dear Niraj Ji,
In a single sentence-Consequential loss is the loss suffered by the insured due to the accident  except the insured property.
Thanks & regards
Biman Banerjee 

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Niraj Bansal

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Sep 1, 2013, 11:45:08 PM9/1/13
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---------- Forwarded message ----------
From: Niraj Bansal <nirajba...@gmail.com>
Date: Mon, Sep 2, 2013 at 9:13 AM
Subject: Re: Two Important Clauses in Motor Policies.
To: "insurance-su...@googlegroups.com" <insurance-su...@googlegroups.com>
Cc: insurance...@googlegroups.com


Dear Surveyors,

Can anyone define about CONSEQUENTIAL LOSS.

Thanks,
NIRAJ KUMAR BANSAL
SLA - 33405
KOTA ( RAJ. )
+919414187262
On Sat, Aug 31, 2013 at 6:23 PM, Binu Varkey <binu.s...@gmail.com> wrote:
Dear Surveyor,
  Please post your valuable opinion on the following clauses in Motor Policy.
 
1.In General Exceptions
A.Any accident loss or damage to any property whatsoever or any loss or expense whatsoever resulting or arising there from or any consequential loss.

 

2.     In Conditions

A.The Insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured.
B.In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are affected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.
 
Regards
 
Binu Varkey

--
Note:
 
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Niraj Bansal

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Sep 1, 2013, 11:43:27 PM9/1/13
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Chand Bhatia

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Sep 3, 2013, 10:40:31 AM9/3/13
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Dear Mr Nitin 

First of all understand that Ombudsman are not a legal authority to be quoted under any court as authority for their judgement. You have quoted one case of Pritoria and I wonder if you are referring to some Ombudsman of that country or case referred in India. 

I am sorry to say that in most of the case you have referred do not fall under the clause of consequential loss. Insurers normally try to push the claim in this clause as this word appears in the policy and it is easy to quote in repudiating the claim. But what Mr Biman Banerjee has written is absolutely correct and this is what is defined in books of Insurance. 

There are various seminars in which this clause has been substantially explained and lately Senior Surveyor Mr Jalan exlained on this clause in details with examples. in a seminar in in Kolkatta, where entire Motor Department of National Insurance Co. HO was present. You have not mentioned your working station/city, otherwise I would have referred to organise a local seminar and call some senior surveyor around to explained you the Consequential Loss Clause in Motor Policy. 

The Ombudsman decisions can not be acceptable, as these are not contested in a manner legal cases are contested, nor they have any judicial status. 

C K BHATIA


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c k bhatia
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