Page 48 - Insurance Times April 2021

LEGAL

Vehicle Insurance

Govt. amends insurance ombudsman and member Meena Ramanathan, was dealing with a
complaint filed by Ch Sudhakara Raju, a resident of Banjara
rules for better resolution of Hills, against Bharati Axa General Insurance Co Ltd. The
policyholders' complaints complainant stated that in September 2013 his car,
purchased for over Rs. 60.21 lakh, was stranded in Jubilee
The Finance Ministry has recently declared that the
Hills due to heavy rains when water overflowed from KBR
government has amended insurance ombudsman rules and
brought insurance brokers within their ambit, allowing National Park. The water entered the car's engine, and it
policyholders to file online complaints. The amended rules would not start. The vehicle was then towed to a workshop
have enlarged the scope of complaints to ombudsmen from on the same night. When this was informed to the opposite
party, it sent an appointed surveyor, and after inspecting
only disputes earlier to deficiencies in service on the part
the vehicle, reported 'hydrostatic loss' which was not
of brokers, insurers, agents and other intermediaries.
covered by the insurance policy.
The timeliness and cost-effectiveness of the mechanism has
been substantially strengthened under the amended rules. The complainant wrote to the opposite parties contending
the outcome of the vehicle inspection as improper. After
Policyholders will now be capable of lodging complaints
electronically to the ombudsman and a complaints this, the complainant engaged the services of an IRDA
management system will also be created to enable surveyor who assessed the damage and noted that it was
policyholders to track the status of their complaints online. due to flood water entering the engine manifold, damaging
its parts. The cost of repair was estimated at over Rs. 20
"Further, insurance brokers have been brought within the lakh. For their part, the opposite party denied all
ambit of the Ombudsman mechanism, by empowering the allegations, and maintained that except Rs. 53,108, no
Ombudsmen to pass awards against insurance brokers as amount is payable by it, and that the damages to the vehicle
well," the Ministry stated. "A number of amendments have are not insured.
been made for securing the independence and integrity of
After taking all submission into consideration, the
the ombudsman selection process, while also building in
safeguards to secure the independence and impartiality of Commission noted that while there was a 'minor lapse' on
the appointed persons while serving as Ombudsmen." the driver's part, 'that by itself cannot be taken as a serious
lapse on her part so as to deny the benefits of the insurance
'Minor lapse on part of driver no reason policy.'
to dismiss insurance claim' The order reads, "Taking into consideration the above facts
and circumstances and the natural human nature and the
Telangana State Consumer Disputes Redressal Commission way in which people conduct themselves, we feel that it
held that a minor lapse on the driver's part is not liable for will be highly unjust, unfair and injustice to the complainant
a claim to be dismissed, and directed an insurance company with the order so as to make her suffer for the act which
to reimburse Rs. 17.54 lakh. she has admittedly committed as has been borne out from

The Commission bench, comprising president MSK Jaiswal the letter Ex.A5. We feel that the interest of justice

48 The Insurance Times, April 2021