CLAIM PROCESS WITH LOSS MINIMISATION

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RISK INSPECTION & PROCESSING
CLAIM WITH LOSS MINIMISATION
A PRESENTATION
By
AJAY K. JAIN
INSPECTION OF MOTOR O.D.
RISK
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SEGMENT OF THE VEHICLE.
CLASS OF VEHICLE.
PURPOSE/ USES OF THE VEHICLE.
PRESENCE OF THE VEHICLE IN THE
MARKET.
REPAIRING NETWORK OF THE VEHICLE.
AVAILABILITY OF SPARE PARTS
AGE/ CONDITION OF THE VEHICLE.
FITMENT OF SAFETY EQUIPMENT.
INSPECTION OF MOTOR O.D.
RISK
 PAST CLAIM EXPERIENCE.
 CONDITION OF WIRING.
 INSPECTION/ VALUATION BY A COMPETENT
PERSON.
 IMPORTANCE OF AGGREGATE NUMBERS.
 CONSIDERATION OF VALUE OF FABRICATED
PARTS SEPARATELY MAINLY IN COMMERCIAL
VEHICLES.
 ANATOMY OF VEHICLE.
AT THE TIME OF CLAIM
INTIMATION FOR SPOT
SURVEY
GUIDE LINES FOR CLAIM PROCESSOR TO MINIMISE LIABILITIES:• Deputation of a competent Surveyor
• The survey should be conducted within 6 hours.
• Police report/ Mutual settlement report should be mandatory for
all trucks/commercial vehicles.
• Guide the surveyor to take proper/ accurate photographs of
damaged vehicle and its documents.
• There must be at least one photograph which should display the
load details.
• Written statement of insured’s representative should be
collected by the spot surveyor.
• All “AGGREGATE NUMBERS” should be noted down by the spot
surveyor.
• The spot surveyor should comment on the requirement of towing
the vehicle.
• Ask the spot surveyor to take down clear observations.
• Submission of spot survey reports within 48 hours.
AT THE TIME OF CLAIM INTIMATION
FOR FINAL SURVEY
GUIDE LINES FOR CLAIM PROCESSORS
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Complete claim documents including police report and court
release order should be collected prior to deputation of a
Surveyor.
A letter/affidavit should be taken from the insured describing
how he brought his vehicle to the workshop.
Clear-cut policy for the value of spare parts purchased from
authorized stockiest/ local market.
Advise the insured to purchase all major spare parts from
authorized stockiest for better performance of the vehicle.
Depute a competent Surveyor.
DURING REPAIRS/ AFTER
CONDUCTING THE FINAL
SURVEY
GUIDE LINES FOR CLAIM PROCESSORS
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To collect an online status report within 48 hours from the surveyor
including photographs.
To discuss the assessment portion with surveyor by keeping “LINE OF
IMPACT” in mind and visit the vehicle if required.
Always encourage the surveyor to allow child parts/bare assemblies
subjected to the availability of those parts. Consult parts catalogue if
required.
Always check that whether the subjected part is an original fitment of that
insured vehicle or not?
The labor charges should be calculated/assessed on “LUMP SUM” basis
in case of major losses by the surveyor.
IDV of fabricated parts like cabin, body etc. should be calculated
separately and their losses should be assessed accordingly.
Approve the claim timely subjected to the policy terms and conditions.
Ask the surveyor to note down the “AGGREGATE NUMBERS” of
damaged/replaced parts during re inspection.
To distinguish between actual losses and “CONSEQUENTIAL LOSSES”.
LINE OF IMPACT
A PRACTICAL ASPECT
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FRONT CENTER IMPACT
FRONT RIGHT IMPACT
FRONT LEFT IMPACT
FRONT UPPER IMPACT
FRONT UNDER CHASSIS IMPACT
RHS IMPACT
LHS IMPACT
REAR IMPACT
OVERTURING IMPACT
LINE OF IMPACT
 Try to find out the initial/starting point of impact.
 Then judge the direction of impact as per the
nature and the cause of losses.
 Locate the end point up to which the impact has
affected the vehicle.
 Insurers are only liable to pay the losses that
occur in between the starting point and end
point.
 Knowledge of the “LOCATION OF PARTS”.
FRONT RIGHT IMPACT
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SOME PHOTOGRAPHS
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PARTS WHICH MAY BE DAMAGED ARE AS UNDER:-
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
Head lamp (for all)
Fender/cowl panel (for all)
Condenser (for cars)
Steering box (for all)
Alternator (for all)
Timing portion (for cars)
A.C. Compressor (for cars)
Turbo charger (for all)
Brake booster (for all)
Coolant bottles and other fitting items (for cars)
Apron/wheel house (for LMV)
Cowl panel (for LMV)
Door post pillar (for LMV)
W/s glass (for all)
Instrument panel (for all)
Control pedals (for all)
Steering rods/ steering column (for all)
Meter cluster and control switches (for all)
Floor panel (for all)
Roof panel (for all)
Driver seat and fitting items (for all)
FRONT CENTER IMPACT
•
SOME PHOTOGRAPHS
•
PARTS WHICH MAY BE DAMAGED ARE AS UNDER:-
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Front bumper (for all)
Silencer (for Tata 4018/3516)
Front grill (for all)
Front member (for LMV)
Condenser/Intercooler (LMV/HTV)
Radiator (for all)
Fan (for all)
Viscous assy./ Water body (for all)
Engine with gear & differential assy./ Engine block (for cars/ for jeep & trucks)
Engine mounting (for all)
Engine cross member (for all)
Flywheel/clutch/gear housings (Jeep and HTV)
Gear cross member (Jeep and HTV)
Propeller shaft (Jeep and HTV)
Differential assy.(Jeep and HTV)
FRONT UNDER CHASSIS IMPACT
•
Some photographs
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Parts which may be damaged are as under:-
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Front bumper (for all)
Front cross member (for all)
Oil pan (for all)
Front suspension parts (for all)
Front axle (for all)
Steering rack and pinion (for LMV)
Floor panel (for LMV)
Silencer assy. (for all)
Rear suspension (for all)
Rear axle (for all)
Fuel tank (for LMV)
FRONT UPPER IMPACT
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Some photographs
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Parts which may be damaged are as under:-
1.
Front member (for LMV)
Cowl/cabin (for trucks)
Bonnet (for LMV)
Head lamps (for LMV)
Air cleaner (for all)
Battery (for LMV)
Cowl panel/dash panel (for all)
Wiper motor/arm/blades/links (for all)
W/s glass (for all)
Front pillars/side bodies (for all)
Roof panel (for all)
Instrument panel and fitting items (for all)
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
FRONT LEFT IMPACT
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1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
SOME PHOTOGRAPHS
PARTS WHICH MAY BE DAMAGED ARE AS UNDER:Front bumper (for all)
Chassis (for LTV and HTV)
Head lamp (for all)
Fender/cowl panel (for all)
Radiator (for LMV)
Air cleaner (for HTV)
Fuel Injection pump (for Jeep and HTV)
Timing portion (for Jeep and HTV)
Air Compressor (for HTV)
Battery (for LMV)
Fuse box and other fitting items (LMV and LTV)
Apron/wheel house (for LMV and LTV)
Cowl panel (for all)
Door post pillar (for LMV and LTV)
W/s glass (for all)
Floor panel
Steering oil container (for HTV)
Roof panel
RHS IMPACT
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1.
2.
3.
4.
5.
6.
7.
8.
Some photographs
Parts which may be damaged are as under:Complete RHS fender to quarter panel (for LMV)
RHS front/rear suspension parts (for all)
RHS cabin/cowl/load body (for HTV)
RHS doors (for LMV)
RHS Pillars/side body panel (for LMV/ HTV)
RHS Floor assy. (for LMV)
Roof panel (for LMV/HTV)
Seats (for LMV)
LHS IMPACT
• Some photographs
• Parts which may be damaged are as under:1. Complete LHS fender to quarter panel (for LMV)
2. LHS front/ rear suspension parts (for all)
3. LHS cabin/cowl/load body (for HTV)
4. LHS doors (for LMV)
5. LHS Pillars/side body panel (for LMV)
6. LHS Floor assy. (for LMV)
7. Roof panel (for LMV)
8. Seats (for LMV)
REAR IMPACT
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Some photographs
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Parts which may be damaged are as under:-
1.
Rear bumper (for all)
Rear member (for LMV)
Rear cross member (for jeep and HTV)
Back door (for LMV)
Back door glass (for LMV)
Dala (for HTV)
Support planks and structure (for HTV)
Door shockers (for LMV)
Chassis frame (for jeep and HTV)
Floor panel (for LMV)
Quarter panels (for LMV)
Roof panel (for LMV)
Fuel tank (for LMV)
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
OVERTURNING IMPACT
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Some photographs
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Parts which may be damaged are as under:-
Body shell/ cabin/ cowl/ load body (for all)
► Engine damages►
1.
2.
Actual losses due to proximate cause
Consequential losses
CONSEQUENTIAL LOSSES
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Parts which are not damaged due to direct impact or
proximate cause are consequential losses.
Parts generally damaged due to consequences of the loss:-
1.
2.
3.
4.
5.
Engine Assy.
Gear Assy.
Differential Assy.
Tyre
Drive shafts (in LMV)
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The parts damaged due to consequences can be easily
distinguished from the nature of damages they attain. For
example deep scratch marks on drive shafts, damaged or
burnt teeth of gears, wear tear on tyres and seizure of
engine.
KNOWING ABOUT
THE ENGINE
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Assembling an engine
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Working of an engine
MODES OF SETTLEMENT
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Repairing basis
Total loss basis
Net of salvage basis
Cash loss basis
HAVE A NICE DAY
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