invitation to discuss details of RSMD & T cover in Std. Fire policies

[shailesh shah]

Hi friends,
May i request views of our learned members on this cover. As we know RSMD is an inbuilt cover available in current Std Fire policy but T- needs an endorsement with extra premium.

What are the minimal documents that one should ask for in ascertaining whether a loss is due to RSMD <any one or more of the set of perils under RSMD> or due to Terrorism.

Can a simple intimation to police be considered as an authentic and adequate proof of loss having taken place due to vandalism - deliberately mischievous or malicious destruction or damage of property under RSMD?

This message is from
Shailesh B. Shah
Vadodara

[swilton .]

AS PER IPC UNDER VARIOUS SECTIONS THERE IS DEFINITIONS FOR THE ABOVE CATEGORY OF ACTS AND THE CONDITIONS OF THE IPC MUST BE COMPLIED WITH.

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with regards

S WILTON AND COMPANY
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" IF GOD BE FOR US WHO CAN BE AGAINST US "
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[shailesh shah]

This message is from
Shailesh B. Shah
Vadodara

---------- Forwarded message ----------
From: shailesh shah <shaile...@gmail.com>
Date: Fri, Jul 20, 2012 at 10:53 AM
Subject: Re: [Adjusters:12441] invitation to discuss details of RSMD & T cover in Std. Fire policies
To: insurance...@googlegroups.com


dear ASAR,
That's an interesting addendum from your end " if the surveyor have any doubt on the claim."

Suppose the Surveyor writes in his report that he is convinced about the credentials of the claim and has verified all the facts by way of interrogating the persons present at the loss location at the time of loss, and other responsible persons for the safety and security of the site, he has to provide the output / inferences of all his efforts on the job and then if the insurers still feel there is some missing element, they might appoint an investigator, which matches with what Mr. Gupta opined.

But, general practice is again to isolate the investigation from surveyor's ambit and allow or bring in an in-depth study of all possibilities through an investigator, and then take a decision. Again it is the insurers decision to judge whether the claim is small or big. For some insurers even series of such claims are small, though each value more than a few lacs.

The world in indian insurance sector is changing very fast dear. Let us enjoy it.   

 
This message is from
Shailesh B. Shah
Vadodara

On Fri, Jul 20, 2012 at 9:30 AM, ASAR <asant...@gmail.com> wrote:

I do agree with the comments of Sri.K.C. Gupta.  Filing of a criminal case and final investigation report are very much necessary necessary.

 

If necessary, the insurer may be requested for arrangement of private investigation, if the surveyor have any doubt on the claim.

 

ASAR

On 19 July 2012 19:23, <KC.G...@nic.co.in> wrote:

If any case has been intimated to police involing act of RSMD and T , the police is bound to investigate as these acts as criminal act under IPC. The police report alongwith copy of investigation report and challan will be documents required for any such claim. In cases involving samll amounts if the insurer is satisfied, the claim can be considered without further insisting upon more documents.

With regards,

K.C GUPTA
Regional MANAGER,
National Insurance Company Ltd.,
Ahemadbad Regional Office,
Phone 079-26581031, IP-300000-204
Mobile -09909920049 (Gujrat), 09829028456 (Rajasthan)
National Insurance Company Ltd.

-----insurance...@googlegroups.com wrote: -----

To: Insurance Adjusters <Insurance...@googlegroups.com>, insurance_surveyors <insurance...@googlegroups.com>
From: shailesh shah
Sent by: insurance...@googlegroups.com
Date: 07/19/2012 05:38PM
Subject: [Adjusters:12439] invitation to discuss details of RSMD & T cover in Std. Fire policies

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Insurance Surveyor,

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Near Indian Oil Bunk,

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asantony...@gmail.com

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[dmpanditrao]

Dear Sir,

I quote from Sri Shailesh Shah's msg.

"Can a simple intimation to police be considered as an authentic and adequate proof of loss having taken place due to vandalism - deliberately mischievous or malicious destruction or damage of property under RSMD?"

I unquote

 

I get a feeling that he seems to be testing whether learned members know or not or what they know and not know?

 

Such intimations to police may come handy for either parties-claimant/insurers in case the matter becomes subjudice.And particularly for estiblishing whether or not the incidence has a doubtful element.If PROVED otherwise than reported by claimant goes in to favour of Insurers.

 

So, no surveyor should brush away importance of  intimation to police as "SIMPLE".it has much deeper meaning and value in it.

 

I invite comments from other group members on the subject.

 

I thank Shailesh Shah for raising a "SIMPLE" doubt which can not be brushed away "so"

with regards

-dmprao/kolhapur

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[Sanjay Shaw]

W are hunched back with instruction of insurer but we have no authority to extract the speculated IPC w r to complainant statement without passing through it to the competant authority.

any way FIR ( first information report ) which may be treated as documents for the allegation but not established. the procedural steps are C R Report ( minimum three month ) and Final report ( minimum six munth )

But we are helpless to go with the prolonged legal proceding period due to prevailing market pressure and compelled to submit report in a conclusive manner within the stipulated period of one month IRDA Norms.

Ditches are laying all around of us and only bitches can help us to make them understand as what we realy mean to with the terms " independent"- without pre-judice opinion

[Denesh Saxena]

Dear All,

Whatever Sri K.C. Gupta has mentioned is correct.

The police final report is definitely required to be taken into
consideration because all the perils under RSMD - T coverage involve
the criminal act / offence which are punishable under various sections
of I.P.C.

Hence from the final report only it would be confirmed that finally
under what sections of I.P.C. the case has been closed or chargesheets
issued which only would establish the nature of crime committed and if
is covered under the scope of perils under RSMD - T coverages.

Warm Regards

D.K. SAXENA
(HALDWANI)
Mob. +91 9837048029

>>> From: shailesh shah **

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[Chand Bhatia]

Dear All

Few mails have appeared on the subject. While Mr K C Gupta has suggested the final report and even chargesheet to be available for claim settlement. Where as Sanjay Shaw expressed that practices are insurer guided. 

Mr Shailesh asked to express views whether a simple intimation to police be considered adequate. My simple thinking is that why do we want that all acts or inacts should be the responsiblity of the insured only and hold him responsible for delay of his claim. Under the criminal law, it is the duty of every citizen to intimate the crime to police. But not to further enter into the complications of ensuring the criminals are caught and chargesheeted and punished. That is the duty of Police and the State. Now for any inefficiency of police, should the insured be punished. I think this will is not only unfair, but even injustice. 

The procedures is that police receives an intimation, which can be written or oral, and registers in Daily Diary. Police looks in for prima facie occurance of a crime and registers an FIR. Now the rest is criminal procedure. In my opinion the intimation of a crime intimated to police should be considered a sufficient duty of insured for getting his claim. If insurance company wants further assistance from law, it can always get a letter of subrogation and in fact does so, and should settle the claim. Insurance companies even take a letter of indemnity from insured and that is to cover the risk. with all these safeguards, insurance companies officer still try to delay the claim settlements and the prevailing practices are just for many other reasons than genuine practices. Group members shall be surprised to know that Public Sector insurance companies claim procedural manual states that in case of vehicle theft, 75% of payment should be made within 30 days on receipt of documents except the final report. It further says that balance payment may be made on final report. It adds that in case the vehicle is retraced after payment of 75% but before the final report, the choice is with insured that does he want the balance payment or repair the vehicle to be repaired. Tell me how many of us have seen this practice from insurers. 

I think the traditional claim settlement has fallen of the track and requires to be made consumer friendly. 

I also suggest that surveyors and Insurance companies should keep a track on court decided case which brought in so many judgements on vital issues. I have seen a judgement in which this has been confirmed by court that simple intimation to Police is enough for claim to be paid by the insurer and if insurance company needs more than they should follow up the case as they do in MACT cases. 

C K BHATIA

On Thu, Jul 19, 2012 at 5:27 PM, dmpanditrao <jaid...@dataone.in> wrote:

--
c k bhatia

09810231248

[Sanjay Shaw]

Dear Sir,

We are the great Indian and we are being re-inforced in gray market where we are getting MVI Report of single pages. Some insurer are pressing us to do assessment as per the quantum of theft/effected item as per the police final report (if it is found mentioned in it )

Some one are asking assessment on the basis of the records and books of accounts.

and in absence of all above, some one are asking report of assessment on the basis of the statistical analysis on lump sum basis On this prolong procedure of report submission if concerned official were found retired or transfer , on proceeding the file by the new official we are facing lot of trouble ( as we are working in grey market / situation of circumstances )

 

If I Will Invite Mr Shailesh B Shah who can provide us the data from the global market about the tie up/ MOU agreement with the CILA Vs Police commissioner of UK or MOU with the Loyd's member Vs Police commissioner of the UK where Loss adjuster of the UK are getting proper institution support That we are not .???????

 

But Why? we are simple spoon of the Insurer's claim official whose steering drift velocity is dependence on the viscosity of the solute and solvent of the such gray medium why not here is existing thresholdd limit of IRDA Regulation whose activation potential is dependent on the complain ingredient.

 

Insurer are forcing us to collect the letter of the subrogarion /bond from insured than who are we? are we surveyor ? and or tout of insurer.

 

It is quite comfortable to be NON IRDA investigator. at least it is not all effected with the stay fields of the IRDA activation potential of complain.

 

We are in the last stage where Mr Rangachari have submitted his committee report on 26th jun 2012 now we are eagerly waiting for the FDI, Insurance act under IRDA act and definition of employee surveyor Vs independent surveyor.

 

It is the point of stability factor that I Really mean too.

[Denesh Saxena]

Dear All,

In the matter under discussion I would like to draw the attentions of
all the concerned that as per IRDA guide lines which in my opinion too
is very right that a survey report must have the conclusion and
clearcut recommendations for the loss under question as payable or not
payable by insurers.

In losses under RSMD coverage the very important & main part of the
investigation has to be done by police only as such the surveyor has
to wait for the filing of final investigation report by the polie to
the competent court of law and the duly accepted by the court copy /
judgement has to be taken into consideration by the surveyors prior to
making any recommendations.

Further in case any difficiency is there on police side then the same
has to be challenged by the concerned insured in the court or
necessary complaints can also be made to the police higher officials.

It is always the duty of insured to prove the mishappening &
circumstances as to either covered under the policy or not. Surveyors
have to analise & workout the submitted evidences / documents only. In
any way any surveyor can not be supposed to recommend any loss as
payable in absence of the necessary evidences etc taking responsiblity
on their head. After all the police is the government's agency and can
not be ignored in such cases.

If any recommendations are made for the payment of the claim in hurry
because of any reasons and insurers do not find the same as proper and
finally the police final report is called on which in turn indicates
that the loss may not be covered under the policy then who would be
held responsible for the unnecessary litigation.

We independent surveyors are placed for providing the justice to both
the parties i.e. insured & insurers and can not be biased with any one
side.

This also becomes the duty of surveyors to resist against the crimes
and false claims lodged with insurers.

However in case insisted in writing by the insurers for early issuing
of the survey report without waiting for the police final report then
the same can be issued subject to the police final report to be called
on by insurers or not as felt necessary by them.

With Best Regards

DK (D.K. SAXENA)
(HALDWANI)

>> **

>> Dear Sir,
>> I quote from Sri Shailesh Shah's msg.
>> "Can a simple intimation to police be considered as an authentic and
>> adequate proof of loss having taken place due to vandalism - deliberately
>> mischievous or malicious destruction or damage of property under RSMD?"
>> I unquote
>>
>> I get a feeling that he seems to be testing whether learned members know
>> or not or what they know and not know?
>>
>> Such intimations to police may come handy for either
>> parties-claimant/insurers in case the matter becomes subjudice.And
>> particularly for estiblishing whether or not the incidence has a doubtful
>> element.If PROVED otherwise than reported by claimant goes in to favour
>> of
>> Insurers.
>>
>> So, no surveyor should brush away importance of intimation to police as
>> "SIMPLE".it has much deeper meaning and value in it.
>>
>> I invite comments from other group members on the subject.
>>
>> I thank Shailesh Shah for raising a "SIMPLE" doubt which can not be
>> brushed away "so"
>> with regards
>> -dmprao/kolhapur
>>
>> ----- Original Message -----

>> *From:* shailesh shah <shaile...@gmail.com>
>> *To:* Insurance Adjusters <Insurance...@googlegroups.com> ;
>> insurance_surveyors <insurance...@googlegroups.com>
>> *Sent:* Thursday, July 19, 2012 3:14 PM
>> *Subject:* {Surveyors:13226} invitation to discuss details of RSMD & T

[shailesh shah]

there are good and bad people on either sides, and it is beyond a normal intellectual person <who is most of the time worried about his earning at the end of the day- as line of survival in this complex world especially the insurance business with its so many complexities by the very nature of paper promise and many loose ends giving enough space for any shrewd claimant to twist the claims in his favor, it be genuine or otherwise> to quickly come at a judicious conclusion of the case of theft/burglary reported to the insurers.

That is why we give ourselves time to examine <not to stress or strain the claimants and put them to merciless pains as felt by some persons trying to speak on behalf of the claimants> all the facts and figures, from all possible angles, and then take a final decision.

Haven't we seen some thing coming up out of blues during deeper investigations by the Insurers through their investigators, which none could have ever imagined at the time of processing claims in the first instance.

Well handling burglary claims and that too with suspected involvement of the malice elements and terrorist groups whether named or unnamed in the Govt. gazettes, is a tricky business and TIME is the best way to deal with the same apart from applying our prudence and knowledge gained through all these years experience.

I conclude that there is no single theory which can always give useful and truthful results at the end of the day, except going though the painful process of systematic analysis of such claims. There is no way we can cook fast food in this region of claims. And i fully support those who believe in a systematic approach than a quickie to please their dear clients.
   

This message is from
Shailesh B. Shah
Vadodara

On Sun, Jul 22, 2012 at 7:43 AM, Chand Bhatia <bhatia...@gmail.com> wrote: